Strategies for overcoming therapeutic inertia in type 2 diabetes: A systematic review and meta-analysis.
glycaemic control
systematic review
type 2 diabetes
Journal
Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
17
05
2021
received:
08
02
2021
accepted:
25
05
2021
pubmed:
29
6
2021
medline:
12
8
2021
entrez:
28
6
2021
Statut:
ppublish
Résumé
To systematically investigate the effect of interventions to overcome therapeutic inertia on glycaemic control in individuals with type 2 diabetes. We electronically searched for randomized controlled trials or quasi-experimental studies published between January 1, 2004 and December 31, 2019 evaluating the effect of interventions on glycated haemoglobin (HbA1c) control. Characteristics of included studies and HbA1c difference between intervention and control arms (main outcome) were extracted. Interventions were grouped as: care management and patient education; nurse or certified diabetes educator (CDE); pharmacist; or physician-based. Thirty-six studies including 22 243 individuals were combined in nonlinear random-effects meta-regressions; the median (range) duration of intervention was 1 year (0.9 to 36 months). Compared to the control arm, HbA1c reduction ranged from: -17.7 mmol/mol (-1.62%) to -4.4 mmol/mol (-0.40%) for nurse- or CDE-based interventions; -13.1 mmol/mol (-1.20%) to 3.3 mmol/mol (0.30%) for care management and patient education interventions; -9.8 mmol/mol (-0.90%) to -6.6 mmol/mol (-0.60%) for pharmacist-based interventions; and -4.4 mmol/mol (-0.40%) to 2.8 mmol/mol (0.26%) for physician-based interventions. Across the included studies, a reduction in HbA1c was observed only during the first year (6 months: -4.2 mmol/mol, 95% confidence interval [CI] -6.2, -2.2 [-0.38%, 95% CI -0.56, -0.20]; 1 year: -1.6 mmol/mol, 95% CI -3.3, 0.1 [-0.15%, 95% CI -0.30, 0.01]) and in individuals with preintervention HbA1c >75 mmol/mol (9%). The most effective approaches to mitigating therapeutic inertia and improving HbA1c were those that empower nonphysician providers such as pharmacists, nurses and diabetes educators to initiate and intensify treatment independently, supported by appropriate guidelines.
Substances chimiques
Glycated Hemoglobin A
0
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2137-2154Informations de copyright
© 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
Références
Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.
Yang W, Dall TM, Beronjia K, et al. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
American Diabetes Association. Introduction: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl. 1):S1-S2.
Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HAW. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-1589.
Khunti K, Davies MJ. Clinical inertia-time to reappraise the terminology? Prim Care Diabetes. 2017;11(2):105-106.
Khunti K, Gomes MB, Pocock S, et al. Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: a systematic review. Diabetes Obes Metab. 2018;20(2):427-437.
Khunti K, Millar-Jones D. Clinical inertia to insulin initiation and intensification in the UK: a focused literature review. Prim Care Diabetes. 2017;11(1):3-12.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210.
Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64:383-394.
Higgins JPT, Tomas JJC, Cumpston M, Li T, Page MJ, et al.. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Training. Chichester: John Wiley & Sons; 2019. https://training.cochrane.org/handbook/current.
StataCorp. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC; 2019.
Al Hamarneh YN, Hemmelgarn BR, Hassan I, Jones CA, Tsuyuki RT. The effectiveness of pharmacist interventions on cardiovascular risk in adult patients with type 2 diabetes: the multicentre randomized controlled RxEACH trial. Can J Diabetes. 2017;41(6):580-586.
Bellido V, Bellido D, Tejera C, et al. Effect of telephone-delivered interventions on glycemic control in type 2 diabetes treated with glargine insulin. Telemed J E Health. 2019;25(6):471-476.
Bieszk N, Grabner M, Wei W, et al. Personalized care and the role of insulin as a vehicle to optimizing treatments in diabetes care. J Manag Care Spec Pharm. 2017;23(11):1160-1168.
Bieszk N, Reynolds SL, Wei W, Davis C, Kamble P, Uribe C. “Act on threes” paradigm for treatment intensification of type 2 diabetes in managed care: results of a randomized controlled study with an educational intervention targeting improved glycemic control. J Manag Care Spec Pharm. 2016;22(9):1028-1038.
Cowart K, Sando K. Pharmacist impact on treatment intensification and hemoglobin A1C in patients with type 2 diabetes mellitus at an academic health center. J Pharm Pract. 2019;32(6):648-654.
Curtis J, Lipke S, Effland S, et al. Effectiveness and safety of medication adjustments by nurse case managers to control hyperglycemia. Diabetes Educ. 2009;35(5):851-856.
Egede LE, Williams JS, Voronca DC, Knapp RG, Fernandes JK. Randomized controlled trial of technology-assisted case management in low income adults with type 2 diabetes. Diabetes Technol Ther. 2017;19(8):476-482.
Fairall LR, Folb N, Timmerman V, et al. Educational outreach with an integrated clinical tool for nurse-led non-communicable chronic disease management in primary care in South Africa: a pragmatic cluster randomised controlled trial. PLoS Med. 2016;13(11):e1002178.
Fiscella K, Volpe E, Winters P, Brown M, Idris A, Harren T. A novel approach to quality improvement in a safety-net practice: concurrent peer review visits. J Natl Med Assoc. 2010;102(12):1231-1236.
Frias J, Virdi N, Raja P, Kim Y, Savage G, Osterberg L. Effectiveness of digital medicines to improve clinical outcomes in patients with uncontrolled hypertension and type 2 diabetes: prospective, open-label, cluster-randomized pilot clinical trial. J Med Internet Res. 2017;19(7):e246.
Furler JS, Blackberry ID, Walker C, et al. Stepping up: a nurse-led model of care for insulin initiation for people with type 2 diabetes. Fam Pract. 2014;31(3):349-356.
Gabbay RA, Añel-Tiangco RM, Dellasega C, Mauger DT, Adelman A, Van Horn DHA. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): results of a 2-year randomized controlled pragmatic trial. J Diabetes. 2013;5(3):349-357.
Greenwood DA, Blozis SA, Young HM, Nesbitt TS, Quinn CC. Overcoming clinical inertia: a randomized clinical trial of a telehealth remote monitoring intervention using paired glucose testing in adults with type 2 diabetes. J Med Internet Res. 2015;17(7):1-16.
Hsu WC, Lau KHK, Huang R, et al. Utilization of a cloud-based diabetes management program for insulin initiation and titration enables collaborative decision making between healthcare providers and patients. Diabetes Technol Ther. 2016;18(2):59-67.
Jameson JP, Baty PJ. Pharmacist collaborative management of poorly controlled diabetes mellitus: a randomized controlled trial. Am J Manag Care. 2010;16(4):250-255.
Kulzer B, Daenschel W, Daenschel I, et al. Integrated personalized diabetes management improves glycemic control in patients with insulin-treated type 2 diabetes: results of the PDM-ProValue study program. Diabetes Res Clin Pract. 2018;144:200-212.
Magee MF, Baker KM, Fernandez SJ, et al. Redesigning ambulatory care management for uncontrolled type 2 diabetes: a prospective cohort study of the impact of a boot camp model on outcomes. BMJ Open Diabetes Res Care. 2019;7(1):1-10.
Magee MF, Nassar CM, Mete M, White K, Youssef GA, Dubin JS. The synergy to enable glycemic control following emergency department discharge program for adults with type 2 diabetes: step-diabetes. Endocr Pract. 2015;21(11):1227-1239.
Manski-Nankervis JA, Furler J, O'Neal D, Ginnivan L, Thuraisingam S, Blackberry I. Overcoming clinical inertia in insulin initiation in primary care for patients with type 2 diabetes: 24-month follow-up of the stepping up cluster randomised controlled trial. Prim Care Diabetes. 2017;11(5):474-481.
Mash R, Chb MB, Ugoagwu A, et al. Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa. South Afr Med J. 2016;106(12):1236-1240.
McFarland M, Davis K, Wallace J, et al. Use of home telehealth monitoring with active medication therapy management by clinical pharmacists in veterans with poorly controlled type 2 diabetes mellitus. Pharmacotherapy. 2012;32(5):420-426.
O'Connor PJ, Sperl-Hillen JA, Johnson PE, Rush WA, Crain AL. Customized feedback to patients and providers failed to improve safety or quality of diabetes care: a randomized trial. Diabetes Care. 2009;32(7):1158-1163.
Phillips LS, Ziemer DC, Doyle JP, et al. An endocrinologist-supported intervention aimed at providers improves diabetes management in a primary care site. Diabetes Care. 2005;28(10):2352-2360.
Piatt GA, Anderson RM, Brooks MM, et al. 3-year follow-up of clinical and behavioral improvements following a multifaceted diabetes care intervention: results of a randomized controlled trial. Diabetes Educ. 2010;36(2):301-309.
Prudencio J, Cutler T, Roberts S, Marin S, Wilson M. The effect of clinical pharmacist-led comprehensive medication management on chronic disease state goal attainment in a patient-centered medical home. J Manag Care Spec Pharm. 2018;24(5):423-429.
Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34(9):1934-1942.
Reutens AT, Hutchinson R, Van Binh T, et al. The GIANT study, a cluster-randomised controlled trial of efficacy of education of doctors about type 2 diabetes mellitus management guidelines in primary care practice. Diabetes Res Clin Pract. 2012;98(1):38-45.
Sharp LK, Tilton JJ, Touchette DR, et al. Community health workers supporting clinical pharmacists in diabetes management: a randomized controlled trial. Pharmacotherapy. 2018;38(1):58-68.
Smith SA, Shah ND, Bryant SC, et al. Randomized trial of an electronic decision support system. Mayo Clin Proc. 2008;83(July):747-757.
Stone RA, Rao RH, Sevick MA, et al. Active care management supported by home telemonitoring in veterans with type 2 diabetes: the DiaTel randomized controlled trial. Diabetes Care. 2010;33(3):478-484.
Tang PC, Overhage JM, Chan AS, et al. Online disease management of diabetes: engaging and motivating patients online with enhanced resources-diabetes (EMPOWER-D), a randomized controlled trial. J Am Med Inform Assoc. 2013;20(3):526-534.
Tilton JJ, Edakkunnathu MG, Moran KM, et al. Impact of a medication therapy management clinic on glycosylated hemoglobin, blood pressure, and resource utilization. Ann Pharmacother. 2019;53(1):13-20.
van Bruggen R, Gorter K, Stolk R, Klungel O, Rutten G. Clinical inertia in general practice: widespread and related to the outcome of diabetes care. Fam Pract. 2009;26(6):428-436.
Von Storch K, Graaf E, Wunderlich M, Rietz C, Polidori MC, Woopen C. Telemedicine-assisted self-management program for type 2 diabetes patients. Diabetes Technol Ther. 2019;21(9):514-521.
Young LA, Buse JB, Weaver MA, et al. Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial. JAMA Intern Med. 2017;177(7):920-929.
Zgibor JC, Maloney MA, Malmi M, et al. Effectiveness of certified diabetes educators following pre-approved protocols to redesign diabetes care delivery in primary care: results of the REMEDIES 4D trial. Contemp Clin Trials. 2018;64(July 2017):201-209.
Coles B, Zaccardi F, Seidu S, et al. Rates and estimated cost of primary care consultations in people diagnosed with type 2 diabetes and comorbidities: a retrospective analysis of 8.9 million consultations. Diabetes Obes Metab. 2021;23(6):1301-1310. https://pubmed.ncbi.nlm.nih.gov/33539642/.
Bower P, Macdonald W, Harkness E, et al. Multimorbidity, service organization and clinical decision making in primary care: a qualitative study. Fam Pract. 2011;28(5):579-587.
Hamel L, Kearny A, Kirzinger A, Lopes L, Muñana C, Brodie M. KFF Health Tracking Poll - May 2020 - Health and Economic Impacts - 9474 | KFF [Internet]. 2020. https://www.kff.org/report-section/kff-health-tracking-poll-may-2020-health-and-economic-impacts/. Accessed May 29, 2020.
Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ. 2008;337:a1655.
DeFronzo RA, Stonehouse AH, Han J, Wintle ME. Relationship of baseline HbA1c and efficacy of current glucose-lowering therapies: a meta-analysis of randomized clinical trials. Diabet Med. 2010;27(3):309-317.
Thompson SG, Higgins JPT. How should meta-regression analyses be undertaken and interpreted? Stat Med. 2002;21(11):1559-1573. https://pubmed.ncbi.nlm.nih.gov/12111920/.