Register      Login
Public Health Research and Practice Public Health Research and Practice Society
The peer-reviewed journal of the Sax Institute
RESEARCH ARTICLE (Open Access)

Primary health care provider–focused interventions for improving outcomes for people with type 2 diabetes: a rapid review

Nighat Faruqi A , Louise Thomas A , Sharon Parker A , Ben Harris-Roxas A , Jane Taggart A , Catherine Spooner A , Vincent Wong B C D and Mark Harris A *
+ Author Affiliations
- Author Affiliations

A Centre for Primary Health Care and Equity, UNSW Sydney, Australia

B Primary Integrated and Community Health, South Eastern Sydney Local Health District, NSW, Australia

C South Western Sydney Clinical School, UNSW Sydney, Australia

D Diabetes and Endocrine Service, Liverpool Hospital, South Western Sydney Local Health District, NSW, Australia

* Correspondence to: m.f.harris@unsw.edu.au

Public Health Research and Practice 29, e29121903 https://doi.org/10.17061/phrp29121903
Published: 4 December 2019

Abstract

Objectives and importance of the study:The bulk of care for people with type 2 diabetes occurs in primary health care. This rapid review evaluated the effectiveness of primary health care provider–focused interventions in improving biochemical, clinical, psychological and health-related quality-of-life outcomes in people with type 2 diabetes. Methods: We searched Medline, Embase, All EBM Reviews, CINAHL, PsycINFO and grey literature focusing on the Organisation for Economic Co-operation and Development (OECD) member countries. We selected studies that targeted adults with type 2 diabetes, described a provider-focused intervention conducted in primary health care, and included an evaluation component. Four researchers extracted data and each included study was assessed for quality by two researchers. Results: Of the 15 studies identified, there was one systematic review (high quality), four randomised controlled trials (RCTs) (two strong quality, one each moderate and weak) and 10 cluster RCTs (two strong quality, five moderate, three weak). The range of follow-up periods was 3–32 months. In all but one study, the intervention was compared against usual care. The applied interventions included: computerised and noncomputerised decision support; culturally tailored interventions; feedback to the healthcare provider on quality of diabetes care; practice nurse involvement; and integrated primary and specialist care. All interventions aimed to improve the biochemical outcomes of interest; 13 studies also included clinical, psychological and/or health-related quality-of-life outcomes. Outcome results were mixed. Conclusions: All interventions had mixed impacts on the outcomes of interest except the one study testing a decision aid, which did not show any improvement. A number of interventions are already available in Australia but need wider adoption. Other effective interventions are yet to be broadly adopted, and need to be evaluated for their applicability, feasibility and sustainability in the Australian context.

2019 © Faruqi et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.