ArticleHealth services research and managerial epidemiology
How Do Interventions That Exemplify the Joint Principles of the Patient Centered Medical Home Affect Hemoglobin A1C in Patients With Diabetes: A Review.
Article in Health services research and managerial epidemiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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
2 citing papers in PubMed.
- Diabetes care improvement in pharmacist- versus nurse-supported patient-centered medical homes.The American journal of managed care · 2017Article
- Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief.Health affairs (Project Hope) · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo review the impact of the Joint Principle of the Patient Centered Medical Home (PCMH) on hemoglobin A1C (HbA1C) in primary care patients with diabetes.
methodsSystematic review of English articles using approximate terms for (1) the 7 principles of the PCMH, (2) primary care, and (3) HbA1C. We included experimental and observational studies. Three authors independently extracted data and obtained summary estimates for concepts with more than 2 high-quality studies.
resultsForty-three studies published between 1998 and 2012 met inclusion criteria, 33 randomized and 10 controlled before-after studies. A physician-directed medical practice (principle 2) lowered HbA1C values when utilizing nursing (mean difference [MD] -0.36, 95% confidence interval [CI] -0.43 to -0.28) or pharmacy care management (MD -0.76; 95% CI -0.93 to -0.59). Whole-person orientation (principle 3) also lowered HbA1C (MD -0.72, 95% CI -0.98 to -0.45). Studies of coordinated and integrated care (principle 4) and quality and safety interventions (principle 5) did not consistently lower HbA1C when reviewed in aggregate. We did not identify high-quality studies to make conclusions for personal physician (principle 1), enhanced access (principle 6), and payment (principle 7).
conclusionOur review found individual interventions that reduced the HbA1C by up to 2.0% when they met the definitions set by of the Joint Principles of the PCMH. Two of the principles-physician-led team and whole-person orientation-consistently lowered the HbA1C. Other principles had limited data or made little to no impact. Based on current evidence, PCMH principles differentially influence the HbA1C, and there are opportunities for additional research.
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Registered trials
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