BACKGROUND: Diabetes is a chronic and complex disease that requires a multidisciplinary collaborative care approach.

OBJECTIVE: The primary objective was to evaluate the clinical outcomes of patients with uncontrolled diabetes within a multidisciplinary collaborative care model. The secondary objective was to evaluate the humanistic and economic outcomes of this model of care.

METHODS: A search using PubMed, SCOPUS, and CINAHL from 2007 to 2017 was conducted. Articles selected included randomized controlled studies on multidisciplinary collaborative care (defined as care provision by >/= two different care providers) versus usual care (defined as standard care provided solely by physicians) for patients with uncontrolled diabetes. In addition, the eligible article had to report at least two of the three outcomes such as clinical (glycated hemoglobin[HbA1c], systolic blood pressure[SBP], low-density lipoprotein[LDL], and triglyceride[TG]), humanistic (patient-reported measures), and economic (healthcare costs and utilizations) outcomes. Parameters examined included study characteristics, care interventions, patient characteristics, and study outcomes. Primary outcomes using mean differences (MDs) with 95% confidence intervals (CIs) were analyzed either by fixed or random-effects models.

RESULTS: A total of 16 studies were included in the review. Multidisciplinary collaborative care significantly improved HbA1c (MD=-0.55%,95% CI=-0.65 to 0.45%, p<0.001, I(2) =35%) and SBP (MD=-4.89mmHg, 95% CI=-6.64 to -3.13mmHg, p<0.001, I(2) =46%) over three to twelve months. The humanistic outcomes in the multidisciplinary collaborative care model were either improved or maintained over time. In comparison to usual care, the healthcare costs and utilizations in the multidisciplinary collaborative care model were comparable without incurring excessive costs.

CONCLUSIONS: Multidisciplinary collaborative care appeared to positively impact on the clinical, humanistic, and economic outcomes of patients with uncontrolled diabetes. This article is protected by copyright. All rights reserved.