Integrated Health Care System Application in Patients With Hypertension and Diabetes: A Systematic Review and Meta-analysis

Abstract

【Background】Integrated health care provide patients with comprehensive and continuous care, but it still no consequence whether it could improve the illness condition of patients who suffer from chronic disease, such as hypertension and diabetes. The objective of this study is to evaluate the effect of the integrated health care system in patients with hypertension and diabetes. 【Methods】Randomised controlled trials testing the effect of integrated health care system in patients with hypertension and diabetes were be included. We search in GIN, NICE, Cochrane, JBI, CINAHL, EMBASE, PUBMED, Web of Science, SINOMED, CNKI (Chinese database), WANFANG (Chinese database) and VIP (Chinese database) databases from the building date of database to 31/Oct/2020. The articles must meet the following inclusion criteria: research objects are patients who have been clearly diagnosed with hypertension and diabetes, all of the articles should use Integrated Health Care as intervention, the study type of article is randomized clinical trials, the articles should be published in Chinese or English. Risk of bias were assessed regarding randomisation, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. 【Results】. 16 randomized controlled trials (seven hypertension, nine diabetes) involving 5,231 patients (2,593 with diabetes and 2,638 with hypertension) with intervention duration ranging from 6 to 24 months. Meta-analysis showed that integrated health care significantly improved systolic and diastolic blood pressure in patients with hypertension, it also significantly declined the level of glycosylated hemoglobin in diabetes. After using the integrated health care for 12 months, glycosylated hemoglobin was significantly decreased which compared to the 6-month intervention in patients with diabetes. 【Discussion】In this study, we undertook a meta-analysis of the published work that systematically evaluated the effects of integrated health care. Integrated Health Care could be beneficial to reduce glycosylated hemoglobin, and control blood pressure in patients with diabetes and hypertension. The diabetes management based on integrated health care is a long-term care process, and it would be effective over time.