Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis

The Lancet, Early Online Publication, 9 June 2012.
The effectiveness of quality improvement (QI) strategies on diabetes care remains unclear. We aimed to assess the effects of QI strategies on glycated haemoglobin (HbA1c), vascular risk management, microvascular complication monitoring, and smoking cessation in patients with diabetes.


We identified studies through Medline, the Cochrane Effective Practice and Organisation of Care database (from inception to July 2010), and references of included randomised clinical trials. We included trials assessing 11 predefined QI strategies or financial incentives targeting health systems, health-care professionals, or patients to improve management of adult outpatients with diabetes. Two reviewers independently abstracted data and appraised risk of bias. Read More