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A systematic review of diabetes disease management programs Knight K; Badamgarav E; Henning JM; Hasselblad V; Gano AD Jr; Ofman JJ; Weingarten SRAm J Manag Care 2005[Apr]; 11 (4): 242-50OBJECTIVE: To systematically evaluate and synthesize published evidence regarding the effect of disease management programs for patients with diabetes mellitus on processes and outcomes of care. STUDY DESIGN: Systematic literature review and meta-analysis. PATIENTS AND METHODS: Computerized databases were searched for English-language controlled studies assessing the effect of diabetes disease management programs published from 1987 to 2001. Two reviewers extracted study data using a structured abstraction form. Pooled estimates of program effects on glycated hemoglobin were calculated using an empirical Bayes model. RESULTS: The pooled estimate of program effects on glycated hemoglobin was a 0.5-percentage point reduction (95% confidence interval, 0.3 to 0.6 percentage points), a modest but significant improvement. Evidence also supports program benefits in improving screening for retinopathy and foot lesions. CONCLUSIONS: Diabetes disease management programs can improve glycemic control to a modest extent and can increase screening for retinopathy and foot complications. Further efforts will be required to create more effective disease management programs for patients with diabetes mellitus.|*Disease Management[MESH]|Blood Pressure[MESH]|Cholesterol/blood[MESH]|Diabetes Complications[MESH]|Diabetes Mellitus/blood/diagnosis/*therapy[MESH]|Humans[MESH]|Monitoring, Physiologic[MESH]|Treatment Outcome[MESH] |
