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Table 3 Effects of interprofessional collaborations in patients at vascular risk

From: Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review

Author year

Main Outcomes

Results

Statistics

Agarwal 2019 [20]

Self-Efficacy for Diabetes scale at 4 months

I = 7,93 C = 7,06 Difference at 4 months = 0.65 95%CI [- 0.11—1.40]

NS

Barceló 2010 [21]

Percent of patients at the target

 

Group comparison at the end

HbA1c < 7%

I = 27.6% to 39.3% C = 20.7% to 27.9%

p = 0.03

Chol-total < 200

I = 65.1% to 76.5% C = 54.1% to 58.6%

NS

BP ≤ 140/90

I = 73.4% to 75.1% C = 72.5% to 69.3%

NS

Foot examination done

I = 49.0% to 95.4% C = 46.8% to 21.6%

p < 0.01

Eye examination done

I = 10.2% to 73.0% C = 3.6% to 4.5%

p < 0.01

Three or more treatment goals

I = 16.6% to 69.7% C = 12.4% to 5.9%

p < 0.01

Benedict 2018 [22]

HbA1c < 8% at 12 months

Adj. OR = 0.88 95%CI [0.72–1.07]

NS

Carter 2009 [23]

Chen 2013 [24]

Improvement in guideline adherence at 6 months

I = 22.4 C = 4.0 Adj. OR = 9.6 95% CI [-2.3—21.5]

NS

Nb of patient with controlled blood pressure

I = 63.9% C = 29.9% Ad. OR = 3.2 95% CI [2.0—5.1]

p < 0.001

SBP variation at 6 months

I = -20.7 C = -6.8 Ad.. effect = -12.0 95% CI [-24.0—0.0]

p < 0.05

DBP variation at 6 months

I = -9.7 C = -4.5 Ad. effect = -1.8 95% CI [-11.9—8.3]

NS

Mean 24-h SBP

I = 135.6 to 120.4 C = 137.0 to 131.8

Baseline NS / 6 months p < 0.001

Patients with controlled SBP(%)

I = 39.8 to 75.6 C = 35.4 to 50.0

Baseline NS / 6 months p < 0.001

Carter 2015 [25]

SBP at 9 months

I = 131.6 C = 138.2

p = 0.002

DBP at 9 months

I = 76.3 C = 78.0

p = 0.005

Carter 2018 [26]

Evolution of Guideline Advantage Score

I = 63.3% to 67.8% (p = 0.02) C = 64.7% to 63.1% (NS)

p = 0.07

Chen 2010 [27]

  

Adj. p-value

LDL-C measured

I = 74.0% to 84.9% C = 56.2% to 72.9% Difference in change = -5.8%

p = 0.001

HbA1c measured

I = 86.9% to 88.9% C = 93.7% to 90.1% Difference in change =  + 5.6%

NS

BP (proportion of patients at goal)

I = 48.7% to 56.5% C = 41.4% to 45.4% Difference in change =  + 3.8%

NS

LDL-C (proportion of patients at goal)

I = 49.1% to 58.6% C = 52.5% to 58.8% Difference in change =  + 3.2%

NS

HbA1C (proportion of patients at goal)

I = 26.7% to 36.7% C = 25.9% to 34.8% Difference in change =  + 1.8%

NS

Choi 2015 [28]

New stroke

I = 2.7% C = 0.8%

NS

Pré to post intervention:

SBP

I = 135.2 to 127.7 C = 135.7 to 134.5 (no difference at baseline)

I: p < 0.01 C: NS

DBP

I = 70.4 to 68.1 C = 73.5 to 72.1 (difference at baseline p < 0.01)

I: p < 0.01 C: p = 0.04

HbA1c

I = 7.2 to 6.5 C = 7.2 to 6.9 (no difference at baseline)

I: p < 0.01 C: p = NS

LDL-C

I = 3.4 to 2.8 C = 3.0 to 3.0 (difference at baseline p < 0.01)

I: p < 0.01 C: p = NS

Ex-smoker

I = 14. % To 18.8% C = 23.3% to 27.1% (no difference at baseline)

I: p < 0.01 C: p < 0 .01

Chwastiak 2017 [29]

Change in HbA1c

Change in SBP

I = -0.9% C = -0,2%

p = 0.008

Outpatient clinic visits

I = -3 mmHg C =  + 1,4 mmHG

p = 0.014

Emergency department visits

I = 14.5 C = 8.3

p < 0.001

I = 1.8 C = 1.5

NS

Edwards 2012 [30]

Proportion of patients with:

HbA1c measured

I = 91,2% C = 76,7% OR 3,13 95%CI [1,52–6,46]

p = 0.0013

LDL-C measured

I = 95,6% C = 70,0% OR 9,26 95%CI [3,60–23,79]

p < 0.0001

Foot exam

I = 87,6% C = 47,6% OR 7,78 95%CI [4,18–14,48]

p < 0.0001

Eye referral

I = 85,8% C = 55,2% OR 5,29 95%CI [2,88–9,72]

p < 0.0001

Pneumococcal vaccine

I = 80,5% C = 37,6% OR 7,26 95%CI [4,19–12,59]

p < 0.0001

Influenza vaccine

I = 74,3% C = 50,0% OR 2,90 95%CI [1,75–4,78]

p < 0.0001

Urine sample

I = 75,2% C = 15,7% OR 17,08 95%CI [9,66–30,21]

p < 0.0001

ElGerges 2020 [31]

HbA1c

Before: I = 8.40 C = 7.7 After: I = 6.8 C = 7.5

Comparison I-C: before p < 0.05 after p < 0.05

SBP

Before: I = 132.0 C = 129 After: I = 125.6 C = 129.0

Comparison I-C: before NS after NS

DBP

Before: I = 81.0 C = 82.2 After: I = 76.2 C = 81.2

Comparison I-C: before NS after p < 0.01

DMSES (Diabetes Management Self-Efficacy Scale)

Before: I = 5.02 C = 4.91 After: I = 8.28 C = 4.85

Comparison I-C: before NS after p < 0.01

SDSCA (Summary of Diabetes Self-Care Activities)

Before: I = 2.89 C = 2.67 After: I = 4.56 C = 2.48

Comparison I-C: before NS after p < 0.01

Fokkens 2011 [32]

Difference after 1 year

HbA1c

I = 0,2 C = 0.2 Adj. OR = 1.8 95%CI[1.03–3.14]

p < 0.05

SBP

I = -2,7 C = 1.0 Adj. OR = 1.54 95%CI [0.99–2.38]

NS

DBP

I = -1,8 C = -0.4 Adj. OR = 2.13 95%CI [1.37–3.32]

p < 0.05

LDL-C

I = -0,2 C = -0.4 Adj. OR = 2.89 95%CI [1.47–5.69]

p < 0.05

Furler 2017 [33]

Change (from baseline to 12 months) in HbA1c

I = -1,3% C = -0,6%

p < 0.001

Heisler 2012 [34]

Relative change in SBP at 6 months

I =—8.9 C = -9.0 -0.18 [-0.77- 1.13]

NS

Jameson 2010 [35]

HbA1C evolution

I = -1.50 C = -0.40

NS

Jiao 2014 [36] / Jiao 2015 [37]

Changes in HbA1c

I = -0,11 C = 0.10

p < 0.01

Observed cardiovascular events

I = 1.21% C = 2.89%

p = 0.003

Predicted 10-year cardiovascular risks Framingham

I = -3.93 C = -1.87

p < 0.01

Time to first occurrence of a major diabetes-related complication:

Hazad ratio I versus C

 

composite of 3 cardio-vascular diseases

0.629 95%CI [0.554, 0.715]

 < 0.001

coronary heart disease

0.570 95%CI [0.470—0.691]

 < 0.001

stroke

0.652 95%CI [0.546—0.780]

 < 0.001

heart failure

0.598 95%CI [0.446—0.802]

0.001

all-cause mortality

0.363 95%CI [0.308—0.428]

 < 0.001

Manns 2012 [38]

Rate of admissions to hospital or visits to emergency departments per 1000 patients/month

I = 1.58 C = 1.96 OR = 0.83 95%CI [0.64, 1.08]

p < 0.001

McAdam-Marx 2015 [39]

HbA1c at 18 months

Baseline HbA1c ≥ 7.0%:

OR ad. -0.212 CI 95% [-0.401—-0.023]

p = 0.028

Baseline HbA1c ≥ 8.0%:

OR ad. -0.381 CI 95% [-0.616 à -0.146]

p = 0.002

Mosques 2010 [40]

Realization rates for:

HbA1c

OR (Ref = control group)

p =  < 0.0001

Microalbuminuria

I = 1.868

p =  < 0.0001

Funduscopy

I = 6.716

NS

Creatinemia

I = 1.207

p =  < 0.0001

ECG

I = 2.761

p =  < 0.0001

Lipid check-up

I = 2.547

p =  < 0.0001

I = 2.154

Mundt 2015 [41]

 

Full Model for Team social network

 

Density:

Centralization

Density

Centralization

BP < 130/80 mmHg

OR = 1.15 [0.99–1.34]

OR = 1.03 [0.85–1.25]

NS

NS

LDL-c < 100 mg/Dl

OR = 1.14 [1.00–1.31]

OR = 0.93 [0.79–1.08]

NS

NS

Nb of urgent care visits

OR = 0.95 [0.55- 1.66]

OR = 1.20 [0.79–1.81]

NS

NS

Nb of emergency department visits

OR = 0.98[0.50–1.89]

OR = 1.33 [0.83–2.13]

NS

NS

Nb hospital visit days

OR = 0.62 [0.50–0.77]

OR = 1.45 [1.09–1.94]

p < 0.001

p < 0.001

Pape 2011 [42]

Patient target: LDL-C <  = 100 mg/dL (%)

I = 78% C = 50%

p = 0.003

LDL-c

I = 83 vs 95

 < 0.001

Simpson 2011 [43] Omran 2015 [44]

 ≥ 10% decrease in SBP at 1 year

I = 37% C = 23% OR 1.91 95% CI [1.11–3.28]

p = 0.02

 >  = 1 hypertensive treatment optimization

I = 42% C = 26% OR = 1.63 95% CI [1.08–2.46]

p = 0.016

Smith 2004 [45]

HbA1c

I = 7.0% C = 6.7%

NS

Smith 2016 [46]

SBP 0 to 9 months

I = 149 to 132 C = 150 to 141

Baseline NS / 9 months p = 0.036

SBP 0 to 9 months

I = 84 to 75 C = 79 to 73

Baseline NS / 9 months NS

BP control at 9 months

I = 34,2% C = 25,9% Ad. OR = 1.92 95% CI [0.33–11.2]

NS

Tahaineh 2011 [47]

Percent of patients at their LDL-c target

I = 94.5% C = 71.2%

p < 0.001

Tobari 2010 [48]

variation at 6 months:

At office:

SBP

I = -2.4 C = -0.9

NS

DBP

I =—2.3 C = -3.1

NS

At home morning

SBP

I = -2.9 C = -1.2

NS

DBP

I = -3.3 C = -1.4

p = 0.04 CI [-5.5; -0.1]

BMI

I = -0.4 C = -0.0

p = 0.008 CI [− 0.7; − 0.1]

Vitale 2020 [49]

Realization of

Overall effect size in OR

 

HbA1c

 = 1.15

NS

BP

 = 1.06

NS

Diabetes management visit

 = 1.22

p = 0.02

LDL-C

 = 0.87

NS

Foot exam

 = 1.19

p = 0.05

Weber 2010 [50]

Change in 24-h mean ambulatory SBP and DBP (mmHg)

Reduction SBP I = -14.1 C = -5.5

p < 0.001

Reduction DBP I = -6.8 C = -2.8

p < 0.001

  1. I group intervention (= IPC), C Control group, OR odds-ratio, CI Confidence interval, Adj. Adjusted, NS non-significant, DBP Diastolic Blood Pressure, SBP Systolic Blood Pressure