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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Dijkstra 2005.

Study characteristics
Methods Introduction of diabetes passports involving both patients and professionals to improve hospital outpatient diabetes care
Cluster‐RCT (9 clusters with 42 providers), conducted in 9 Dutch general hospitals, the Netherlands
Two arms: 1. Control (control arm) and 2. Intervention (intervention arm)
Participants Control arm N: 750
Intervention arm N: 600
Diabetes type: type 1 and type 2
Mean age: 58.0 ± 15.5
% Male: 48.0
Longest follow‐up: 12 months
Interventions Control arm:
None
Intervention arm:
1) Audit and feedback
2) Clinician education
3) Facilitated relay of clinical information
4) Patient education
Outcomes 1) Retinopathy screening (eye exam), N screened (%)
Control arm: pre 351 (84), post 370 (89)
Intervention arm: pre 308 (88), post 330 (94)
2) Foot screening, N screened (%)
Control arm: pre 145 (35), post 171 (41)
Intervention arm: pre 123 (35), post 183 (52)
3a) Renal screening (creatinine), N screened (%)
Control arm: pre 343 (82), post 363 (87)
Intervention arm: pre 280 (80), post 298 (85)
3b) Renal screening (renal), N screened (%)
Control arm: pre 329 (79), post 343 (82)
Intervention arm: pre 238 (68), post 270 (77)
4) HbA1c, mean % (SD)
Control arm: pre 8.0 (1.2), post 8.2 (NR)
Intervention arm: pre 8.1 (1.3), post 7.8 (NR)
5) SBP, mean mmHg (SD)
Control arm: pre 144.9 (21.4), post 144.7 (NR)
Intervention arm: pre 143.7 (22.5), post 144.8 (NR)
6) DBP, mean mmHg (SD)
Control arm: pre 78.7 (11.0), post 79.7 (NR)
Intervention arm: pre 79.9 (10.4), post 79.2 (NR)
Funding source This study was supported by a grant from The Netherlands Ministry of Health, Welfare and Sport (Grant number: 68659754527226605897)
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Report that it was done by someone outside their department.
Allocation concealment (selection bias) Low risk Information not available.
Provider's baseline characteristics (selection bias) High risk The number of beds was higher at the control hospitals and they also had more DSNs.
Patient's baseline characteristics (selection bias) High risk Table 1. No P values provided; large difference in patient numbers between groups; numbers otherwise were somewhat consistent
Patient's baseline outcomes (selection bias) Unclear risk No P values reported
Incomplete outcome data (attrition bias) Low risk Information not available.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) Low risk Information not available.
Selective reporting (reporting bias) Low risk Information not available.
Risk of contamination (other bias) Low risk Information not available.
Other bias Low risk Information not available.