Improving Management of Diabetes Mellitus in Primary Care

A Cochrane review [Abstract] 1 included 41 studies with a total of 48 000 subjects. The methodological quality of the studies was often poor. Multifaceted professional interventions enhanced the performance of health professionals. Organisational interventions that improve regular prompted recall can improve diabetes management. The effect on patient outcomes remains unclear because they were assessed in only two studies. One of the these studies did not demonstrate an effect, and the study that reported a positive effect had a limited methodological quality. Addition of patient-oriented interventions can lead to improved health outcomes. Studies that featured greater involvement of nurses in diabetes management reported positive effects on patient outcomes. Studies that reported a positive effect on patient outcome tended to include patient education.

Comment: The quality of evidence is downgraded by indirectness and limitations in study methodology.

The following decision support rules contain links to this evidence summary:

• Recall of patients with diabetes http://www.ebmeds.org/ebmeds/ebmeds_home.asp?mode=scripts&submode=view&id=scr00492&country=UK

References

• Renders CM, Valk GD, Griffin S, Wagner EH, Eijk JThM van, Assendelft WJJ. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database Syst Rev. 2000;(4):CD001481.