Diversity in Diabetes Care Programmes and Views on High Quality Diabetes Care: Are We in Need of a Standardized Framework?

Overview

Journal Int J Integr Care

Publisher Ubiquity Press

Date 2008 May 22

PMID 18493592

Citations 15

Authors

Liesbeth A D Borgermans

Geert Goderis

Marielle Ouwens

Johan Wens

Jan Heyrman

Richard P T M Grol

Affiliations

Soon will be listed here.

Abstract

Objectives: To explore views on high quality diabetes care based on an analysis of existing diversity in diabetes care programmes and related quality indicators.

Methods: A review of systematic reviews was performed. Four databases (MEDLINE database of the National Library of Medicine, COCHRANE database of Systematic Reviews, the Cumulative Index to Nursing and Allied Health Database-CINAHL and Pre-Cinahl) were searched for English review articles published between November 1989 and December 2006. Methodological quality of the articles was assessed. A standardized extraction form was used to assess features of diabetes care programmes and diabetes quality indicators with special reference to those aspects that hinder the conceptualization of high quality diabetes care. Based on these findings the relationship between diversity in diabetes care programmes and the conceptualization of high quality diabetes care was further explored.

Results: Twenty-one systematic reviews met the inclusion criteria representing a total of 185 diabetes care programmes. Six elements were identified to produce a picture of diversity in diabetes care programmes and hinder their standardization: 1) the variety and relative absence of conceptual backgrounds in diabetes care programmes, 2) confusion over what is considered a constituent of a diabetes care program and components of the implementation strategy, 3) large variety in type of diabetes care programmes, settings and related goals, 4) a large number and variety in interventions and quality indicators used, 5) no conclusive evidence on effectiveness, 6) no systematic results on costs.

Conclusions: There is large diversity in diabetes care programmes and related quality indicators. From this review and our analysis on the mutual relationship between diversity in diabetes care programmes and the conceptualization of high quality diabetes care, we conclude that no single conceptual framework used to date provides a comprehensive overview of attributes of high quality diabetes care linked to quality indicators at the structure, process and outcome level. There is a need for a concerted action to develop a standardized framework on high quality diabetes care that is complemented by a practical tool to provide guidance to the design, implementation and evaluation of diabetes care programmes.

Citing Articles

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Quality indicators in type 2 diabetes patient care: analysis per care-complexity level.

Schneiders J, Telo G, Grabinski Bottino L, Pasinato B, Neyeloff J, Schaan B Diabetol Metab Syndr. 2019; 11:34.

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Impact of a primary healthcare quality improvement program on diabetes in Canada: evaluation of the Quality Improvement and Innovation Partnership (QIIP).

Reichert S, Harris S, Tompkins J, Belle-Brown J, Fournie M, Green M BMJ Open Diabetes Res Care. 2018; 5(1):e000392.

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Results from the CLUES study: a cluster randomized trial for the evaluation of cardiovascular guideline implementation in primary care in Spain.

Etxeberria A, Alcorta I, Perez I, Emparanza J, Ruiz de Velasco E, Iglesias M BMC Health Serv Res. 2018; 18(1):93.

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Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

Paquette-Warren J, Harris S, Hayward M, Tompkins J J Eval Clin Pract. 2016; 22(5):644-52.

PMID: 26804339 PMC: 5066647. DOI: 10.1111/jep.12510.

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