SynthesisPloS one2013
Improving diabetes care in rural areas: a systematic review and meta-analysis of quality improvement interventions in OECD countries.
Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 44 citations in OpenAlex.
- Closing the rural diabetes research gap: a case for coordinated international collaboration.Global health action · 2026Article
- National adult mortality trends due to chronic kidney disease-related atrial fibrillation in the United States from year 2011-2020.World journal of cardiology · 2025Article
- Child Development Allied Health Services in Rural and Remote Areas: A Systematic Scoping Review of Drivers, Barriers and Enabling Strategies to Delivery of Services.The Australian journal of rural health · 2025Article
- Strategies to Improve Health Care Provider Prescription of and Patient Adherence to Guideline-Recommended Cardiovascular Medications for Atherosclerotic Occlusive Disease: Protocol for Two Systematic Reviews and Meta-Analyses of Randomized Controlled Trials.JMIR research protocols · 2025Article
- Association between residing in municipalities facing population decline and satisfaction with neighboring healthcare infrastructure in older aged adults.BMC public health · 2024Article
- Service quality: perspective of people with type 2 diabetes mellitus and hypertension in rural and urban public primary healthcare centers in Iran.BMC health services research · 2024Article
- Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network.Joint Commission journal on quality and patient safety · 2024Article
- Diabetic foot complications among Indigenous peoples in Canada: a scoping review through theFrontiers in endocrinology · 2023Article
- Article
- Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia - a realist synthesis regarding hypertension and diabetes.BMC public health · 2021Review
- Diagnostic validity of the pre-diabetes scale among at-risk rural Iranian adults for screening for pre-diabetes.Journal of diabetes and metabolic disorders · 2020Article
- Evaluating implementation and impact of a provincial quality improvement collaborative for the management of chronic diseases in primary care: the COMPAS+ study protocol.BMC family practice · 2020Article
- Review of 128 quality of care mechanisms: A framework and mapping for health system stewards.Health policy (Amsterdam, Netherlands) · 2020Review
- Diabetes care in the dispersed population of Greenland. A new model based on continued monitoring, analysis and adjustment of initiatives taken.International journal of circumpolar health · 2019Article
- Retrospective assessment of the quality of diabetes care in a rural diabetes clinic in Western Kenya.BMC endocrine disorders · 2018Article
- Effectiveness of an integrated diabetes care package at primary healthcare facilities: a cluster randomised trial in Pakistan.BJGP open · 2018Article
- Implementation and clinical effectiveness of a community-based non-communicable disease treatment programme in rural Mexico: a difference-in-differences analysis.Health policy and planning · 2018Article
- Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices.Annals of family medicine · 2018Article
- Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study.BMC health services research · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsDespite well documented disparities in health and healthcare in rural communities, evidence in relation to quality improvement (QI) interventions in those settings is still lacking. The main goals of this work were to assess the effectiveness of QI strategies designed to improve diabetes care in rural areas, and identify characteristics associated with greater success.
methodsWe conducted a systematic review and meta-analysis. Systematic electronic searches were conducted in MEDLINE, EMBASE, CINAHL, and 12 additional bibliographic sources. Experimental studies carried out in the OECD member countries assessing the effectiveness of QI interventions aiming to improve diabetes care in rural areas were included. The effect of the interventions and their impact on glycated hemoglobin was pooled using a random-effects meta-analysis.
resultsTwenty-six studies assessing the effectiveness of twenty QI interventions were included. Interventions targeted patients (45%), clinicians (5%), the health system (15%), or several targets (35%), and consisted of the implementation of one or multiple QI strategies. Most of the interventions produced a positive impact on processes of care or diabetes self-management, but a lower effect on health outcomes was observed. Interventions with multiple strategies and targeting the health system and/or clinicians were more likely to be effective. Six QI interventions were included in the meta-analysis (1,496 patients), which showed a significant reduction in overall glycated hemoglobin of 0.41 points from baseline in those patients receiving the interventions (95% CI -0.75% to -0.07%).
conclusionsThis work identified several characteristics associated with successful interventions to improve the quality of diabetes care in rural areas. Efforts to improve diabetes care in rural communities should focus on interventions with multiple strategies targeted at clinicians and/or the health system, rather than on traditional patient-oriented interventions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.