Aspects of Multicomponent Integrated Care Promote Sustained Improvement in Surrogate Clinical Outcomes: A Systematic Review and Meta-analysis.

ABSTRACT:

Objective

The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes.

Research design and methods

We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes. Two reviewers extracted data and appraised the reporting quality.

Results

In a meta-analysis of 181 trials (N = 135,112), random-effects modeling revealed pooled mean differences in HbA_1c of -0.28% (95% CI -0.35 to -0.21) (-3.1 mmol/mol [-3.9 to -2.3]),

SUBMITTER: Lim LL 

PROVIDER: S-EPMC5961399 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature