Health Serv Res. 2013 Feb 28. doi: 10.1111/1475-6773.12048. [Epub ahead of print]
Do Clinical Standards for Diabetes Care Address Excess Risk for Hypoglycemia in Vulnerable Patients? A Systematic Review.
Source
Division of General Internal Medicine, Massachussets General Hospital, Boston, MA 02114.Abstract
OBJECTIVE:
To determine whether diabetes clinical standards consider increased hypoglycemia risk in vulnerable patients.DATA SOURCES:
MEDLINE, the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, and supplemental sources.STUDY DESIGN:
Systematic review of clinical standards (guidelines, quality metrics, or pay-for-performance programs) for glycemic control in adult diabetes patients. The primary outcome was discussion of increased risk for hypoglycemia in vulnerable populations.DATA COLLECTION/EXTRACTION METHODS:
Manuscripts identified were abstracted by two independent reviewers using prespecified inclusion/exclusion criteria and a standardized abstraction form.PRINCIPAL FINDINGS:
We screened 1,166 titles, and reviewed 220 manuscripts in full text. Forty-four guidelines, 17 quality metrics, and 8 pay-for-performance programs were included. Five (11 percent) guidelines and no quality metrics or pay-for-performance programs met the primary outcome.CONCLUSIONS:
Clinical standards do not substantively incorporate evidence about increased risk for hypoglycemia in vulnerable populations.© Health Research and Educational Trust.
- PMID:
- 23445498
- [PubMed - as supplied by publisher]
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