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• W3103264034 startingPage "e1003434" @default.
• W3103264034 abstract "Background Effective health system interventions may help address the disproportionate burden of diabetes in low- and middle-income countries (LMICs). We assessed the impact of health system interventions to improve outcomes for adults with type 2 diabetes in LMICs. Methods and findings We searched Ovid MEDLINE, Cochrane Library, EMBASE, African Index Medicus, LILACS, and Global Index Medicus from inception of each database through February 24, 2020. We included randomized controlled trials (RCTs) of health system interventions targeting adults with type 2 diabetes in LMICs. Eligible studies reported at least 1 of the following outcomes: glycemic change, mortality, quality of life, or cost-effectiveness. We conducted a meta-analysis for the glycemic outcome of hemoglobin A1c (HbA1c). GRADE and Cochrane Effective Practice and Organisation of Care methods were used to assess risk of bias for the glycemic outcome and to prepare a summary of findings table. Of the 12,921 references identified in searches, we included 39 studies in the narrative review of which 19 were cluster RCTs and 20 were individual RCTs. The greatest number of studies were conducted in the East Asia and Pacific region ( n = 20) followed by South Asia ( n = 7). There were 21,080 total participants enrolled across included studies and 10,060 total participants in the meta-analysis of HbA1c when accounting for the design effect of cluster RCTs. Non-glycemic outcomes of mortality, health-related quality of life, and cost-effectiveness had sparse data availability that precluded quantitative pooling. In the meta-analysis of HbA1c from 35 of the included studies, the mean difference was −0.46% (95% CI −0.60% to −0.31%, I 2 87.8%, p < 0.001) overall, −0.37% (95% CI −0.64% to −0.10%, I 2 60.0%, n = 7, p = 0.020) in multicomponent clinic-based interventions, −0.87% (−1.20% to −0.53%, I 2 91.0%, n = 13, p < 0.001) in pharmacist task-sharing studies, and −0.27% (−0.50% to −0.04%, I 2 64.1%, n = 7, p = 0.010) in trials of diabetes education or support alone. Other types of interventions had few included studies. Eight studies were at low risk of bias for the summary assessment of glycemic control, 15 studies were at unclear risk, and 16 studies were at high risk. The certainty of evidence for glycemic control by subgroup was moderate for multicomponent clinic-based interventions but was low or very low for other intervention types. Limitations include the lack of consensus definitions for health system interventions, differences in the quality of underlying studies, and sparse data availability for non-glycemic outcomes. Conclusions In this meta-analysis, we found that health system interventions for type 2 diabetes may be effective in improving glycemic control in LMICs, but few studies are available from rural areas or low- or lower-middle-income countries. Multicomponent clinic-based interventions had the strongest evidence for glycemic benefit among intervention types. Further research is needed to assess non-glycemic outcomes and to study implementation in rural and low-income settings." @default.
• W3103264034 created "2020-11-23" @default.
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• W3103264034 date "2020-11-12" @default.
• W3103264034 modified "2023-10-11" @default.
• W3103264034 title "Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis" @default.
• W3103264034 cites W1768426171 @default.
• W3103264034 cites W1815444468 @default.
• W3103264034 cites W1843428540 @default.
• W3103264034 cites W1934142626 @default.
• W3103264034 cites W1947763202 @default.
• W3103264034 cites W1973914781 @default.
• W3103264034 cites W1978746763 @default.
• W3103264034 cites W1982388655 @default.
• W3103264034 cites W1990086179 @default.
• W3103264034 cites W1991764944 @default.
• W3103264034 cites W2000036477 @default.
• W3103264034 cites W2008507055 @default.
• W3103264034 cites W2024770222 @default.
• W3103264034 cites W2033585778 @default.
• W3103264034 cites W2043861297 @default.
• W3103264034 cites W2045086428 @default.
• W3103264034 cites W2049032499 @default.
• W3103264034 cites W2056451814 @default.
• W3103264034 cites W2063717627 @default.
• W3103264034 cites W2064904280 @default.
• W3103264034 cites W2078220401 @default.
• W3103264034 cites W2099623926 @default.
• W3103264034 cites W2112043259 @default.
• W3103264034 cites W2125913020 @default.
• W3103264034 cites W2143760768 @default.
• W3103264034 cites W2145555293 @default.
• W3103264034 cites W2150000950 @default.
• W3103264034 cites W2153622485 @default.
• W3103264034 cites W2154147073 @default.
• W3103264034 cites W2156098321 @default.
• W3103264034 cites W2165010366 @default.
• W3103264034 cites W2172853499 @default.
• W3103264034 cites W2183117831 @default.
• W3103264034 cites W2283223592 @default.
• W3103264034 cites W2290138478 @default.
• W3103264034 cites W2309619121 @default.
• W3103264034 cites W2333553925 @default.
• W3103264034 cites W2338167986 @default.
• W3103264034 cites W2395076976 @default.
• W3103264034 cites W2419510371 @default.
• W3103264034 cites W246286872 @default.
• W3103264034 cites W2466635600 @default.
• W3103264034 cites W2470269599 @default.
• W3103264034 cites W2518684644 @default.
• W3103264034 cites W2553986939 @default.
• W3103264034 cites W2554606173 @default.
• W3103264034 cites W2571166006 @default.
• W3103264034 cites W2580547582 @default.
• W3103264034 cites W2730331548 @default.
• W3103264034 cites W2788814931 @default.
• W3103264034 cites W2794924570 @default.
• W3103264034 cites W2802807553 @default.
• W3103264034 cites W2804684793 @default.
• W3103264034 cites W2805207040 @default.
• W3103264034 cites W2883493213 @default.
• W3103264034 cites W2891108238 @default.
• W3103264034 cites W2904555355 @default.
• W3103264034 cites W2907210594 @default.
• W3103264034 cites W2912728555 @default.
• W3103264034 cites W2918851286 @default.
• W3103264034 cites W2922691146 @default.
• W3103264034 cites W2938680857 @default.
• W3103264034 cites W2944862226 @default.
• W3103264034 cites W2951182088 @default.
• W3103264034 cites W2965390203 @default.
• W3103264034 cites W2968162793 @default.
• W3103264034 cites W2972436870 @default.
• W3103264034 cites W2972780199 @default.
• W3103264034 cites W2990312646 @default.
• W3103264034 cites W2991464311 @default.
• W3103264034 cites W3006464267 @default.
• W3103264034 cites W4294215472 @default.
• W3103264034 cites W4297918764 @default.
• W3103264034 cites W8357788 @default.
• W3103264034 cites W2517994134 @default.
• W3103264034 doi "https://doi.org/10.1371/journal.pmed.1003434" @default.
• W3103264034 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/7660583" @default.
• W3103264034 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/33180775" @default.
• W3103264034 hasPublicationYear "2020" @default.
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