The impact of interventions on appointment and clinical outcomes for individuals with diabetes: a systematic review

• Published in: BMC health services research 2015-09, Vol.15 (1), p.355-355, Article 355
• Main Authors: Nuti, Lynn, Turkcan, Ayten, Lawley, Mark A, Zhang, Lingsong, Sands, Laura, McComb, Sara
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Appointments and Schedules; Blood pressure; Clinical outcomes; Diabetes; Diabetes Mellitus, Type 1 - therapy; Diabetes Mellitus, Type 2 - therapy; Disease management; Disease prevention; Evidence-based medicine; Eye examinations; Female; Glucose; High density lipoprotein; Humans; Intervention; Literature reviews; Male; Medical records; Medical research; Medicine, Experimental; Middle Aged; Outcome Assessment (Health Care); Patient education; Patients; Preventive medicine; Primary care; Research Design; Schedules; Self Care; Systematic review; Text Messaging; Triglycerides; United States; Vaccines; Young Adult
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-015-0938-5

Successful diabetes disease management involves routine medical care with individualized patient goals, self-management education and on-going support to reduce complications. Without interventions that facilitate patient scheduling, improve attendance to provider appointments and provide patient information to provider and care team, preventive services cannot begin. This review examines interventions based upon three focus areas: 1) scheduling the patient with their provider; 2) getting the patient to their appointment, and; 3) having patient information integral to their diabetes care available to the provider. This study identifies interventions that improve appointment management and preparation as well as patient clinical and behavioral outcomes. A systematic review of the literature was performed using MEDLINE, CINAHL and the Cochrane library. Only articles in English and peer-reviewed articles were chosen. A total of 77 articles were identified that matched the three focus areas of the literature review: 1) on the schedule, 2) to the visit, and 3) patient information. These focus areas were utilized to analyze the literature to determine intervention trends and identify those with improved diabetes clinical and behavioral outcomes. The articles included in this review were published between 1987 and 2013, with 46 of them published after 2006. Forty-two studies considered only Type 2 diabetes, 4 studies considered only Type 1 diabetes, 15 studies considered both Type 1 and Type 2 diabetes, and 16 studies did not mention the diabetes type. Thirty-five of the 77 studies in the review were randomized controlled studies. Interventions that facilitated scheduling patients involved phone reminders, letter reminders, scheduling when necessary while monitoring patients, and open access scheduling. Interventions used to improve attendance were letter reminders, phone reminders, short message service (SMS) reminders, and financial incentives. Interventions that enabled routine exchange of patient information included web-based programs, phone calls, SMS, mail reminders, decision support systems linked to evidence-based treatment guidelines, registries integrated with electronic medical records, and patient health records. The literature review showed that simple phone and letter reminders for scheduling or prompting of the date and time of an appointment to more complex web-based multidisciplinary programs with patient self-management can have a positive impa