Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993–2012) – 20-Year systematic review

Shivashankar, Roopa ; Kirk, Katy ; Kim, Woon Cho ; Rouse, Chaturia ; Tandon, Nikhil ; Venkat Narayan, K. M. ; Ali, Mohammed K. (2015) Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993–2012) – 20-Year systematic review Diabetes Research and Clinical Practice, 107 (2). pp. 203-223. ISSN 0168-8227

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Official URL: http://www.sciencedirect.com/science/article/pii/S...

Related URL: http://dx.doi.org/10.1016/j.diabres.2014.11.004


Objective: To assess the extent to which people with diabetes in Low- and Middle-Income Countries (LMIC) of Asia and the Middle East met evidence-based care recommendations through a systematic review of published literature. Methods: Electronic searches of Medline and Embase were carried out for studies assessing quality of care among people with diabetes in Asia and the Middle East between 1993 and 2012. Benchmarking against American Diabetes Association guidelines, we reported level and proportions meeting recommended risk factor control (glycated hemoglobin [HbA1c], blood pressure, and low density Lipoprotein-cholesterol [LDL]) and preventive care processes across different settings. Results: One hundred and fifteen publications met eligibility for inclusion (91 reported risk factor control, 7 reported preventive processes, and 17 reported both). Only China, Thailand, Malaysia and Philippines had nationally representative data. Mean HbA1c (6.5–11 % or 48–97 mmol/mol), SBP (120–152 mm Hg) and LDL (2.4–3.8 mmol/l) varied greatly. Despite variation in availability of data, studies consistently showed that recommended care goals were not being achieved. Conclusions: The practice of auditing and benchmarking against evidence-based guidelines appears to be uncommon in Asia and the Middle East and there was heterogeneity of reporting across studies, populations and methods used. The available data showed inadequate care.

Item Type:Article
Source:Copyright of this article belongs to Elsevier Science.
Keywords:Diabetes Mellitus; Quality of Care; Asia; Middle East; Developing Countries
ID Code:106927
Deposited On:25 Jun 2017 17:37
Last Modified:25 Jun 2017 17:37

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