QI strategy . | HbA1c (NGSP) . | HbA1c (IFCC) . | ||||||
---|---|---|---|---|---|---|---|---|
≥8% . | <8% . | ≥64 mmol/mol . | <64 mmol/mol . | |||||
N . | MD (95% CI) . | N . | MD (95% CI) . | N . | MD (95% CI) . | N . | MD (95% CI) . | |
Health system | ||||||||
Case management | 23 | −0.40 (−0.54 to −0.26) | 21 | −0.08 (−0.13 to −0.03) | 23 | −4.4 (−5.9 to −2.8) | 21 | −0.9 (−1.4 to −0.3) |
Team change | 24 | −0.46 (−0.63 to −0.29) | 20 | −0.37 (−0.59 to −0.15) | 24 | −5.0 (−6.9 to −3.2) | 20 | −4.0 (−6.4 to −1.6) |
Electronic patient registry | 2 | −0.43 (−0.68 to −0.19) | 5 | −0.07 (−0.13 to −0.02) | 2 | −4.7 (−7.4 to −2.1) | 5 | −0.8 (−1.4 to −0.2) |
Facilitated relay | 23 | −0.36 (−0.53 to −0.20) | 13 | −0.12 (−0.18 to −0.06) | 23 | −3.9 (−5.8 to −2.2) | 13 | −1.3 (−2.0 to −0.7) |
E-health | 17 | −0.29 (−0.41 to −0.17) | 12 | −0.06 (−0.12 to 0.00) | 17 | −3.2 (−4.5 to −1.9) | 12 | −0.7 (−1.3 to 0.0) |
Continuous QI | 10 | −0.36 (−0.56 to −0.15) | 5 | −0.09 (−0.14 to −0.03) | 10 | −3.9 (−6.1 to −1.6) | 5 | −1.0 (−1.5 to −0.3) |
HCPs | ||||||||
Audit and feedback | 4 | −0.50 (−0.51 to −0.49) | 10 | −0.04 (−0.10 to 0.02) | 4 | −5.5 (−5.6 to −5.4) | 10 | −0.4 (−1.1 to −0.2) |
Clinician education | 6 | −0.32 (−0.51 to −0.13) | 6 | −0.15 (−0.28 to −0.02) | 6 | −3.5 (−5.6 to −1.4) | 6 | −1.6 (−3.1 to −0.2) |
Clinician reminder | 22 | −0.31 (−0.46 to −0.17) | 14 | −0.07 (−0.14 to 0.00) | 22 | −3.4 (−5.0 to −1.9) | 14 | −0.8 (−1.5 to 0.0) |
Patients | ||||||||
Patient education | 16 | −0.46 (−0.60 to −0.32) | 13 | −0.12 (−0.18 to −0.07) | 16 | −5.0 (−6.6 to −3.5) | 13 | −1.3 (−2.0 to −0.8) |
Promotion of self-management | 32 | −0.39 (−0.51 to −0.26) | 20 | −0.22 (−0.39 to −0.05) | 32 | −4.3 (−5.6 to −2.8) | 20 | −2.4 (−4.3 to −0.5) |
Patient reminder system | 29 | −0.36 (−0.50 to −0.22) | 16 | −0.08 (−0.14 to −0.02) | 29 | −3.9 (−5.5 to −2.4) | 16 | −0.9 (−1.5 to −0.2) |
SBP | DBP | |||||||
≥140 mmHg | <140 mmHg | ≥80 mmHg | <80 mmHg | |||||
N | MD (95% CI) | N | MD (95% CI) | N | MD (95% CI) | N | MD (95% CI) | |
Health system | ||||||||
Case management | 14 | −2.7 (−4.6 to −0.8) | 15 | −2.9 (−4.7 to −1.0) | 15 | −1.3 (−2.4 to −0.1) | 12 | −1.6 (−2.6 to −0.7) |
Team change | 14 | −5.2 (−7.3 to −3.0) | 14 | −2.3 (−3.6 to −1.0) | 23 | −1.5 (−2.5 to −0.6) | 7 | −1.1 (−1.3 to −1.0) |
Electronic patient registry | 3 | −4.9 (−7.6 to −2.2) | 4 | −4.0 (−7.6 to −0.4) | 5 | −3.3 (−5.0 to −1.6) | 3 | −1.9 (−5.8 to 2.1) |
Facilitated relay | 12 | −4.4 (−7.1 to −1.8) | 15 | −2.7 (−4.4 to −1.0) | 11 | −1.6 (−3.1 to 0.0) | 10 | −1.5 (−2.2 to −0.9) |
E-health | 9 | −2.6 (−5.0 to −0.2) | 10 | −2.0 (−4.4 to 0.4) | 10 | −1.7 (−3.3 to 0.0) | 8 | −1.6 (−2.9 to −0.2) |
Continuous QI | 6 | −4.7 (−7.2 to −2.2) | 7 | −1.1 (−2.8 to 0.6) | 5 | −1.7 (−3.9 to 0.5) | 5 | −0.9 (−2.2 to 0.5) |
HCPs | ||||||||
Audit and feedback | 9 | −3.2 (−6.5 to 0.0) | 2 | −2.9 (−7.0 to 1.3) | 6 | −1.9 (−4.2 to 0.3) | 6 | −1.3 (−1.8 to −0.7) |
Clinician education | 5 | −2.5 (−8.0 to 3.1) | 2 | −4.5 (−7.4 to −1.5) | 6 | −0.9 (−2.9 to 1.2) | 2 | −1.2 (−2.8 to 0.4) |
Clinician reminder | 12 | −2.8 (−5.4 to −0.3) | 9 | −4.3 (−6.5 to −2.0) | 15 | −0.7 (−1.9 to 0.4) | 8 | −1.4 (−3.0 to 0.1) |
Patients | ||||||||
Patient education | 15 | −5.1 (−7.3 to −3.0) | 8 | −2.9 (−5.9 to 0.1) | 17 | −1.8 (−2.9 to −0.8) | 5 | −2.8 (−4.6 to −0.9) |
Promotion of self-management | 18 | −4.7 (−6.7 to −2.7) | 20 | −2.4 (−3.9 to −0.9) | 23 | −1.7 (−2.6 to −0.8) | 13 | −1.5 (−2.0 to −1.0) |
Patient reminder system | 14 | −3.2 (−5.6 to −0.8) | 11 | −2.9 (−4.8 to −1.0) | 16 | −1.5 (−2.8 to −0.3) | 9 | −1.3 (−1.8 to −0.9) |
LDL-C* | ||||||||
≥3.4 mmol/L | <3.4 mmol/L | |||||||
N | MD (95% CI) | N | MD (95% CI) | |||||
Health system | ||||||||
Case management | 2 | −0.20 (−0.27 to −0.14) | 21 | −0.07 (−0.14 to 0.00) | ||||
Team change | 4 | −0.31 (−0.60 to −0.02) | 18 | −0.15 (−0.24 to −0.06) | ||||
Electronic patient registry | NA | NA | 3 | −0.13 (−0.26 to 0.01) | ||||
Facilitated relay | 4 | −0.39 (−0.62 to −0.17) | 20 | −0.12 (−0.19 to −0.04) | ||||
E-health | NA | NA | 16 | −0.10 (−0.18 to −0.02) | ||||
Continuous QI | NA | NA | 6 | −0.10 (−0.25 to 0.04) | ||||
HCPs | ||||||||
Audit and feedback | 2 | −0.33 (−0.62 to −0.04) | 6 | −0.06 (−0.22 to 0.09) | ||||
Clinician education | NA | NA | 5 | −0.12 (−0.27 to 0.04) | ||||
Clinician reminder | NA | NA | 17 | −0.08 (−0.16 to 0.00) | ||||
Patients | ||||||||
Patient education | 4 | −0.23 (−0.48 to 0.01) | 10 | −0.11 (−0.21 to −0.02) | ||||
Promotion of self-management | 4 | −0.23 (−0.48 to 0.01) | 23 | −0.13 (−0.20 to −0.06) | ||||
Patient reminder system | 4 | −0.31 (−0.60 to −0.02) | 16 | −0.06 (−0.14 to 0.01) |
QI strategy . | HbA1c (NGSP) . | HbA1c (IFCC) . | ||||||
---|---|---|---|---|---|---|---|---|
≥8% . | <8% . | ≥64 mmol/mol . | <64 mmol/mol . | |||||
N . | MD (95% CI) . | N . | MD (95% CI) . | N . | MD (95% CI) . | N . | MD (95% CI) . | |
Health system | ||||||||
Case management | 23 | −0.40 (−0.54 to −0.26) | 21 | −0.08 (−0.13 to −0.03) | 23 | −4.4 (−5.9 to −2.8) | 21 | −0.9 (−1.4 to −0.3) |
Team change | 24 | −0.46 (−0.63 to −0.29) | 20 | −0.37 (−0.59 to −0.15) | 24 | −5.0 (−6.9 to −3.2) | 20 | −4.0 (−6.4 to −1.6) |
Electronic patient registry | 2 | −0.43 (−0.68 to −0.19) | 5 | −0.07 (−0.13 to −0.02) | 2 | −4.7 (−7.4 to −2.1) | 5 | −0.8 (−1.4 to −0.2) |
Facilitated relay | 23 | −0.36 (−0.53 to −0.20) | 13 | −0.12 (−0.18 to −0.06) | 23 | −3.9 (−5.8 to −2.2) | 13 | −1.3 (−2.0 to −0.7) |
E-health | 17 | −0.29 (−0.41 to −0.17) | 12 | −0.06 (−0.12 to 0.00) | 17 | −3.2 (−4.5 to −1.9) | 12 | −0.7 (−1.3 to 0.0) |
Continuous QI | 10 | −0.36 (−0.56 to −0.15) | 5 | −0.09 (−0.14 to −0.03) | 10 | −3.9 (−6.1 to −1.6) | 5 | −1.0 (−1.5 to −0.3) |
HCPs | ||||||||
Audit and feedback | 4 | −0.50 (−0.51 to −0.49) | 10 | −0.04 (−0.10 to 0.02) | 4 | −5.5 (−5.6 to −5.4) | 10 | −0.4 (−1.1 to −0.2) |
Clinician education | 6 | −0.32 (−0.51 to −0.13) | 6 | −0.15 (−0.28 to −0.02) | 6 | −3.5 (−5.6 to −1.4) | 6 | −1.6 (−3.1 to −0.2) |
Clinician reminder | 22 | −0.31 (−0.46 to −0.17) | 14 | −0.07 (−0.14 to 0.00) | 22 | −3.4 (−5.0 to −1.9) | 14 | −0.8 (−1.5 to 0.0) |
Patients | ||||||||
Patient education | 16 | −0.46 (−0.60 to −0.32) | 13 | −0.12 (−0.18 to −0.07) | 16 | −5.0 (−6.6 to −3.5) | 13 | −1.3 (−2.0 to −0.8) |
Promotion of self-management | 32 | −0.39 (−0.51 to −0.26) | 20 | −0.22 (−0.39 to −0.05) | 32 | −4.3 (−5.6 to −2.8) | 20 | −2.4 (−4.3 to −0.5) |
Patient reminder system | 29 | −0.36 (−0.50 to −0.22) | 16 | −0.08 (−0.14 to −0.02) | 29 | −3.9 (−5.5 to −2.4) | 16 | −0.9 (−1.5 to −0.2) |
SBP | DBP | |||||||
≥140 mmHg | <140 mmHg | ≥80 mmHg | <80 mmHg | |||||
N | MD (95% CI) | N | MD (95% CI) | N | MD (95% CI) | N | MD (95% CI) | |
Health system | ||||||||
Case management | 14 | −2.7 (−4.6 to −0.8) | 15 | −2.9 (−4.7 to −1.0) | 15 | −1.3 (−2.4 to −0.1) | 12 | −1.6 (−2.6 to −0.7) |
Team change | 14 | −5.2 (−7.3 to −3.0) | 14 | −2.3 (−3.6 to −1.0) | 23 | −1.5 (−2.5 to −0.6) | 7 | −1.1 (−1.3 to −1.0) |
Electronic patient registry | 3 | −4.9 (−7.6 to −2.2) | 4 | −4.0 (−7.6 to −0.4) | 5 | −3.3 (−5.0 to −1.6) | 3 | −1.9 (−5.8 to 2.1) |
Facilitated relay | 12 | −4.4 (−7.1 to −1.8) | 15 | −2.7 (−4.4 to −1.0) | 11 | −1.6 (−3.1 to 0.0) | 10 | −1.5 (−2.2 to −0.9) |
E-health | 9 | −2.6 (−5.0 to −0.2) | 10 | −2.0 (−4.4 to 0.4) | 10 | −1.7 (−3.3 to 0.0) | 8 | −1.6 (−2.9 to −0.2) |
Continuous QI | 6 | −4.7 (−7.2 to −2.2) | 7 | −1.1 (−2.8 to 0.6) | 5 | −1.7 (−3.9 to 0.5) | 5 | −0.9 (−2.2 to 0.5) |
HCPs | ||||||||
Audit and feedback | 9 | −3.2 (−6.5 to 0.0) | 2 | −2.9 (−7.0 to 1.3) | 6 | −1.9 (−4.2 to 0.3) | 6 | −1.3 (−1.8 to −0.7) |
Clinician education | 5 | −2.5 (−8.0 to 3.1) | 2 | −4.5 (−7.4 to −1.5) | 6 | −0.9 (−2.9 to 1.2) | 2 | −1.2 (−2.8 to 0.4) |
Clinician reminder | 12 | −2.8 (−5.4 to −0.3) | 9 | −4.3 (−6.5 to −2.0) | 15 | −0.7 (−1.9 to 0.4) | 8 | −1.4 (−3.0 to 0.1) |
Patients | ||||||||
Patient education | 15 | −5.1 (−7.3 to −3.0) | 8 | −2.9 (−5.9 to 0.1) | 17 | −1.8 (−2.9 to −0.8) | 5 | −2.8 (−4.6 to −0.9) |
Promotion of self-management | 18 | −4.7 (−6.7 to −2.7) | 20 | −2.4 (−3.9 to −0.9) | 23 | −1.7 (−2.6 to −0.8) | 13 | −1.5 (−2.0 to −1.0) |
Patient reminder system | 14 | −3.2 (−5.6 to −0.8) | 11 | −2.9 (−4.8 to −1.0) | 16 | −1.5 (−2.8 to −0.3) | 9 | −1.3 (−1.8 to −0.9) |
LDL-C* | ||||||||
≥3.4 mmol/L | <3.4 mmol/L | |||||||
N | MD (95% CI) | N | MD (95% CI) | |||||
Health system | ||||||||
Case management | 2 | −0.20 (−0.27 to −0.14) | 21 | −0.07 (−0.14 to 0.00) | ||||
Team change | 4 | −0.31 (−0.60 to −0.02) | 18 | −0.15 (−0.24 to −0.06) | ||||
Electronic patient registry | NA | NA | 3 | −0.13 (−0.26 to 0.01) | ||||
Facilitated relay | 4 | −0.39 (−0.62 to −0.17) | 20 | −0.12 (−0.19 to −0.04) | ||||
E-health | NA | NA | 16 | −0.10 (−0.18 to −0.02) | ||||
Continuous QI | NA | NA | 6 | −0.10 (−0.25 to 0.04) | ||||
HCPs | ||||||||
Audit and feedback | 2 | −0.33 (−0.62 to −0.04) | 6 | −0.06 (−0.22 to 0.09) | ||||
Clinician education | NA | NA | 5 | −0.12 (−0.27 to 0.04) | ||||
Clinician reminder | NA | NA | 17 | −0.08 (−0.16 to 0.00) | ||||
Patients | ||||||||
Patient education | 4 | −0.23 (−0.48 to 0.01) | 10 | −0.11 (−0.21 to −0.02) | ||||
Promotion of self-management | 4 | −0.23 (−0.48 to 0.01) | 23 | −0.13 (−0.20 to −0.06) | ||||
Patient reminder system | 4 | −0.31 (−0.60 to −0.02) | 16 | −0.06 (−0.14 to 0.01) |
IFCC, International Federation of Clinical Chemistry and Laboratory Medicine; MD, mean difference; N, number of trials with analyzable data; NA, no available trials for analysis; NGSP, National Glycohemoglobin Standardization Program.
*To convert LDL-C to mg/dL, multiply by 38.67.