Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Italy.
Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Italy.
Health Policy. 2018 Aug;122(8):866-877. doi: 10.1016/j.healthpol.2018.06.003. Epub 2018 Jul 12.
The increasing prevalence of type 2 diabetes has highlighted the importance of evidence-based guidelines for effective prevention, management and treatment. Diabetes self-management education (SME) produces positive effects on patient behaviours and health status. We analyzed the literature to identify (i) the level of integration between usual care and SME programs and (ii) any possible differences across them in terms of outcomes. Searches were made on three databases - PubMed, Scopus and Web of Science - to identify relevant publications on diabetes SME to 2015, which also describe the provider of usual care. In total, 49 studies met the inclusion criteria. We identified three levels of integration (high, medium and low) between usual care and SME programs based on the level of involvement of usual care professionals within the SME programs. In most cases, the primary care physician was responsible for the diabetes patients. Patient health behaviors and/or outcomes improve in most of the studies, independently from the level of integration. However, findings suggest that when patients/participants could perceive that usual care provider is highly involved in SME delivery, educational programs produced results that appear to be more positive.
2 型糖尿病患病率的不断增加突显了循证指南在有效预防、管理和治疗方面的重要性。糖尿病自我管理教育（SME）对患者行为和健康状况产生积极影响。我们分析了文献，以确定（i）常规护理和 SME 计划之间的整合程度，以及（ii）它们在结果方面的任何可能差异。在 PubMed、Scopus 和 Web of Science 这三个数据库中进行了检索，以确定到 2015 年与糖尿病 SME 相关的、同时也描述常规护理提供者的相关出版物。共有 49 项研究符合纳入标准。我们根据常规护理专业人员在 SME 计划中的参与程度，确定了常规护理和 SME 计划之间的三个整合水平（高、中、低）。在大多数情况下，初级保健医生负责糖尿病患者的治疗。大多数研究中，患者的健康行为和/或结果都有所改善，而与整合水平无关。然而，研究结果表明，当患者/参与者能够感觉到常规护理提供者高度参与 SME 服务时，教育计划产生的结果似乎更为积极。
