Quality improvement strategies at primary care level to reduce inequalities in diabetes care: an equity-oriented systematic review

BMC Endocrine Disorders
Natalie TerensMarina Davoli

Abstract

There is evidence that disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications, and the quality of diabetes care. A wide range of interventions has been implemented and evaluated to improve diabetes care. We aimed to review trials of quality improvement (QI) interventions aimed to reduce health inequities among people with diabetes in primary care and to explore the extent to which experimental studies addressed and reported equity issues. Pubmed, EMBASE, CINAHL, and the Cochrane Library were searched to identify randomized controlled studies published between January 2005 and May 2016. We adopted the PROGRESS Plus framework, as a tool to explore differential effects of QI interventions across sociodemographic and economic factors. From 1903 references fifty-eight randomized trials met the inclusion criteria (with 17.786 participants), mostly carried out in USA. The methodological quality was good for all studies. Almost all studies reported the age, gender/sex and race distribution of study participants. The majority of trials additionally used at least one further PROGRESS-Plus factor at baseline, with education being the most commonly used, followed by income (55%). Large variation w...Continue Reading

References

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Citations

Jan 23, 2020·Diabetic Medicine : a Journal of the British Diabetic Association·R A S CampbellUNKNOWN Scottish Diabetes Research Network Epidemiology Group
May 26, 2020·International Journal for Equity in Health·Rubén Silva-TinocoDiddier Prada
Aug 24, 2021·Clinical Diabetes : a Publication of the American Diabetes Association·Olivia Z B GinnardDaniel J DeSalvo

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Software Mentioned

Plus
Cochrane
PRISMA
RevMan
PROGRESS

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