Table A1: Summary of Existing Evidence on Specialized Multidisciplinary Community Care for the Management of Type 2 Diabetes (n=9).
| Study (type, search years)* | No. of trials | Objective | Applicability to MAS analysis |
|---|---|---|---|
| Glazier, et al, 2006 (37) (SR, 1986-2004) | 17 | To determine the effectiveness of patient, provider and health system interventions to improve diabetes care among socially disadvantaged populations. | Did not restrict to articles that were specialized or multidisciplinary in nature, restricted to populations with low socioeconomic status |
| Knight, et al, 2005 (20) (MA, 1987-2001) | 24 | To determine the effect of disease management programs for patients with diabetes on processes and outcomes of care | Not all studies involved specialized multidisciplinary care; meta-analysis had significant clinical and statistical heterogeneity and no attempt of subgroup analysis |
| Norris, et al, 2002 (38) (SR, 1966-2000) | 42 | To determine the effectiveness and economic efficiency of disease management and case management for people with diabetes. | Not all included articles involved specialized multi-disciplinary care; did not report HbA1c or SBP outcomes |
| O’Reilly, et al, 2006 (39) (SR, 1993-2005) | 24 | To determine the efficacy/effectiveness of multidisciplinary primary care interventions and diabetes programs to improve the management of patients with type 2 diabetes in a variety of delivery settings | Relevant review on multidisciplinary care for diabetes management; However, do not describe inclusion criteria of the intervention (i.e. characteristics of the diabetes programs) |
| Renders, et al, 2000 (40) (SR, 1966-2000) | 41 | To determine the effectiveness of interventions targeted at health care professionals and/or the structure of care to improve the management of diabetes in primary care, outpatient and community settings. | Although some interventions involved multidisciplinary teams, not all included involved interventions that were multidisciplinary |
| Shojania, et al, 2006 (21) (MR, 1966-2006) | 66 | To assess the impact of 11 distinct strategies for quality improvement in adults with type 2 diabetes (audit and feedback, case management, team changes, electronic patient registry, clinician education, clinician reminders, facilitated relay of clinical information to clinicians, patient education, promotion of self-management, patient reminder systems and continuous quality improvement) | Not all team changes or case management involved specialized multidisciplinary care |
| van Bruggen, et al, 2007 (41) (SR, 1990-2005)) | 22 | To determine if shared care and allocated care tasks lead to improved quality in diabetes care and a reduction in the cardiovascular risks in diabetes patients. | Different inclusion/exclusion criteria; not all were multidisciplinary care; included delegated care (action being allocated to someone with a lower level of training) |
| Whittemore, et al, 2007 (42) (SR, 1990-2006) | 11 | To describe interventional components and efficacy (clinical outcomes, behavioural outcomes, knowledge) of multifaceted, culturally competent interventions aimed at improving outcomes in Hispanic adults with type 2 diabetes; to describe cultural strategies of the interventions; and to examine factors associated with attendance and attrition | Focus on Hispanic adult diabetic population; not all included studies involved multidisciplinary care |
| Wubben, et al, 2008 (43) (SR, 1937-2007) | 21 | To assess the impact of diabetes quality improvement strategies that used pharmacists in outpatient settings on improvement of glycemic control and other direct outcomes for diabetic adults. | Focused on integration of a pharmacist specifically into team; however, not all studies were multidisciplinary |
*
SR, Systematic review; MA, meta-analysis; MR, meta-regression
†
HbA1c, glycosylated hemoglobin; SBP, systolic blood pressure;