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Am J Prev Med. 2019 Jul;57(1):e17-e26. doi: 10.1016/j.amepre.2019.02.005.

Team-Based Care to Improve Diabetes Management: A Community Guide Meta-analysis.

Author information

1
Community Guide Branch, Division of Public Health Information Dissemination, Atlanta, Georgia.
2
Community Guide Branch, Division of Public Health Information Dissemination, Atlanta, Georgia. Electronic address: ypeng@cdc.gov.
3
Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Departments of Global Health and Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
4
Department of Medicine, University of Chicago, Chicago, Illinois.
5
Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
6
Office of Behavioral and Social Science Research, NIH, Washington, District of Columbia.
7
Indian Health Services, Bethesda, Maryland.

Abstract

CONTEXT:

Team-based care has been increasingly used to deliver care for patients with chronic conditions, but its effectiveness for managing diabetes has not been systematically assessed.

EVIDENCE ACQUISITION:

RCTs were identified from two sources: a high-quality, broader review comparing 11 quality improvement strategies for diabetes management (database inception to July 2010), and an updated search using the same search strategy (July 2010-October 2015).

EVIDENCE SYNTHESIS:

Thirty-five studies were included in the current review; a majority focused on patients with Type 2 diabetes. Teams included patients, their primary care providers, and one or two additional healthcare professionals (most often nurses or pharmacists). Random effect meta-analysis showed that, compared with controls, team-based care was associated with greater reductions in blood glucose levels (-0.5% in HbA1c, 95% CI= -0.7, -0.3) and greater improvements in blood pressure and lipid levels. Interventions also increased the proportion of patients who reached target blood glucose, blood pressure, and lipid levels, based on American Diabetes Association guidelines available at the time. Data analysis was completed in 2016.

CONCLUSIONS:

For patients with Type 2 diabetes, team-based care improves blood glucose, blood pressure, and lipid levels.

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