Implementation and evaluation of a decision support system for type II diabetes

Interventions in primary care to improve cardiovascular risk factors and glycated haemoglobin (HbA1c) levels in patients with diabetes: a systematic review

“…The majority of included studies were randomized controlled trials [27–45] and (cluster‐)randomized controlled trials [26,46–83], with nine controlled before‐and‐after studies [84–92], and one controlled clinical trial [93] (Tables S1 and S2). Studies were mostly conducted in the United States (n = 26) [28,31,32,35–40,44,45,51,52,55,57,58, 60,64,65,68,69,73,75,82,83,93], UK (n = 14) [27,29,34,42,46, 47,54,61,67,74,77,78,81,92] and The Netherlands (n = 11) [30,43,49,63,66,70,79,84,86,89,91]. Settings were PC practices or general practices, although 20 (PC or general medicine) clinics [28,31,36–38,41,44,45,50,52,55,57,58,64,72,76,87,88,93] and two studies on collaboration between hospitals/clinics and PC [32,33] were included as well.…”

“…Eighteen studies only used professional interventions [26,36,46–58,60,62,64], 2 organizational interventions [34,93] and 11 patient‐centred interventions [27,29–31,35,37,38,43,59,61,63]. The effect of two or three combined categories of interventions (professional, organizational and patient centred) was evaluated in 37 studies [28,32,33,39–42,44,45,65–92].…”

“…The majority of included studies were randomized controlled trials [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] and (cluster-)randomized controlled trials [26,, with nine controlled before-andafter studies [84][85][86][87][88][89][90][91][92], and one controlled clinical trial [93] (Tables S1 and S2). Studies were mostly conducted in the United States (n = 26) [28,31,32,[35][36][37][38][39][40]44,45,51,52,55,57,58,60,64,65,68,…”

“…), HbA1C (<7%), FBG, SBP, percentage of patients with SBP > 150, cholesterol, percentage of patients with cholesterol >5 mM and TG. Results for all‐cause mortality, first myocardial infarction, HbA1c, SBP, serum creatinine and the percentage of patients with hypertension improved significantly in one study [90] while another [92] reported significant effects in an HbA1c‐threshold classification (higher percentage of patients with HbA1c <7.5% and lower percentage of patients with HbA1c > 11.9% in the intervention than in the control group).…”

Area‐wide diabetes care: the Lanarkshire experience with primary health care teams 1994–1997

“…In an English survey 42 % of 61 FHSAs reported that they had no policy for helping primary care introduce protocols for the management or referral of diabetic patients. 17 Bearing this in mind there are now initiatives under way in Lanarkshire to support general practices in their care of diabetic patients, and to improve co-ordination between GP and hospital services. 15 The Derbyshire Study 11 reports recording levels in primary care of 10.6 % for BMI, 29.2 % for HbA 1c , 29.8 % for blood pressure (BP), 6.6 % for proteinuria, 1.3 % for fundoscopy, and 3.8 % for foot examination.…”