Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0195086
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dc.titleAssessing the influence of health systems on type 2 diabetes mellitus awareness, treatment, adherence, and control: A systematic review
dc.contributor.authorOng S.E.
dc.contributor.authorKai Koh J.J.
dc.contributor.authorToh S.-A.E.S.
dc.contributor.authorChia K.S.
dc.contributor.authorBalabanova D.
dc.contributor.authorMcKee M.
dc.contributor.authorPerel P.
dc.contributor.authorLegido-Quigley H.
dc.date.accessioned2020-03-23T06:21:48Z
dc.date.available2020-03-23T06:21:48Z
dc.date.issued2018
dc.identifier.citationOng S.E., Kai Koh J.J., Toh S.-A.E.S., Chia K.S., Balabanova D., McKee M., Perel P., Legido-Quigley H. (2018). Assessing the influence of health systems on type 2 diabetes mellitus awareness, treatment, adherence, and control: A systematic review. PLoS ONE 13 (3) : e0195086. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0195086
dc.identifier.issn19326203
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/165904
dc.description.abstractBackground Type 2 Diabetes Mellitus (T2DM) is reported to affect one in 11 adults worldwide, with over 80% of T2DM patients residing in low-to-middle-income countries. Health systems play an integral role in responding to this increasing global prevalence, and are key to ensuring effective diabetes management. We conducted a systematic review to examine the health system-level factors influencing T2DM awareness, treatment, adherence, and control. Methods and findings A protocol for this study was published on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42016048185). Studies included in this review reported the effects of health systems factors, interventions, policies, or programmes on T2DM control, awareness, treatment, and adherence. The following databases were searched on 22 February 2017: Medline, Embase, Global health, LILACS, Africa-Wide, IMSEAR, IMEMR, and WPRIM. There were no restrictions on date, language, or study designs. Two reviewers independently screened studies for eligibility, extracted the data, and screened for risk of bias. Thereafter, we performed a narrative synthesis. A meta-analysis was not conducted due to methodological heterogeneity across different aspects of included studies. 93 studies were included for qualitative synthesis; 7 were conducted in LMICs. Through this review, we found two key health system barriers to effective T2DM care and management: financial constraints faced by the patient and limited access to health services and medication. We also found three health system factors that facilitate effective T2DM care and management: the use of innovative care models, increased pharmacist involvement in care delivery, and education programmes led by healthcare professionals. Conclusions This review points to the importance of reducing, or possibly eliminating, out-of-pocket costs for diabetes medication and self-monitoring supplies. It also points to the potential of adopting more innovative and integrated models of care, and the value of task-sharing of care with pharmacists. More studies which identify the effect of health system arrangements on various outcomes, particularly awareness, are needed. © 2018 Ong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.publisherPublic Library of Science
dc.sourceUnpaywall 20200320
dc.subjectattitude to illness
dc.subjectcost
dc.subjectcost benefit analysis
dc.subjectdiabetes control
dc.subjecteducation program
dc.subjectgeographic distribution
dc.subjecthealth auxiliary
dc.subjecthealth care
dc.subjecthealth care access
dc.subjecthealth care delivery
dc.subjecthealth care financing
dc.subjecthealth care management
dc.subjecthealth care policy
dc.subjecthealth care quality
dc.subjecthealth care utilization
dc.subjecthealth impact assessment
dc.subjecthealth insurance
dc.subjecthuman
dc.subjectlow income country
dc.subjectmedication compliance
dc.subjectmiddle income country
dc.subjectnon insulin dependent diabetes mellitus
dc.subjectnurse
dc.subjectpatient care
dc.subjectpatient compliance
dc.subjectpeer group
dc.subjectpharmacist
dc.subjectprevalence
dc.subjectprogram evaluation
dc.subjectqualitative analysis
dc.subjectReview
dc.subjectrisk assessment
dc.subjectself monitoring
dc.subjectsystematic review
dc.subjecttherapy effect
dc.subjecttreatment outcome
dc.subjecttreatment response
dc.subjectattitude to health
dc.subjectglobal health
dc.subjecthealth care organization
dc.subjecthealth care planning
dc.subjecthealth care policy
dc.subjecthealth service
dc.subjectnon insulin dependent diabetes mellitus
dc.subjectpsychology
dc.subjectDelivery of Health Care
dc.subjectDiabetes Mellitus, Type 2
dc.subjectGlobal Health
dc.subjectHealth Knowledge, Attitudes, Practice
dc.subjectHealth Policy
dc.subjectHealth Services
dc.subjectHealth Systems Agencies
dc.subjectHealth Systems Plans
dc.subjectHumans
dc.typeReview
dc.contributor.departmentSAW SWEE HOCK SCHOOL OF PUBLIC HEALTH
dc.contributor.departmentMEDICINE
dc.description.doi10.1371/journal.pone.0195086
dc.description.sourcetitlePLoS ONE
dc.description.volume13
dc.description.issue3
dc.description.pagee0195086
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