Understanding Gaps in the Hypertension and Diabetes Care Cascade: Systematic Scoping Review

被引:2
|
作者
Wang, Jie [1 ]
Tan, Fangqin [1 ]
Wang, Zhenzhong [1 ]
Yu, Yiwen [1 ]
Yang, Jingsong [1 ]
Wang, Yueqing [1 ]
Shao, Ruitai [1 ]
Yin, Xuejun [1 ,2 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Sch Populat Med & Publ Hlth, 31 Beijige San Tiao, Beijing 10000, Peoples R China
[2] Univ New South Wales, George Inst Global Hlth, Sydney, Australia
来源
JMIR PUBLIC HEALTH AND SURVEILLANCE | 2024年 / 10卷
关键词
care cascade; hypertension; diabetes; scoping review; hypertension and diabetes care; review; BLOOD-PRESSURE; HEALTH-CARE; MEDICATION ADHERENCE; SELF-MANAGEMENT; ADULT PATIENTS; GLYCEMIC CONTROL; AMBULATORY-CARE; UNMET NEEDS; LOW-INCOME; CONTINUITY;
D O I
10.2196/51802
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Hypertension and diabetes are global health challenges requiring effective management to mitigate their considerable burden. The successful management of hypertension and diabetes requires the completion of a sequence of stages, which are collectively termed the care cascade. Objective: This scoping review aimed to describe the characteristics of studies on the hypertension and diabetes care cascade and identify potential interventions as well as factors that impact each stage of the care cascade. Methods: The method of this scoping review has been guided by the framework by Arksey and O'Malley. We systematically searched MEDLINE, Embase, and Web of Science using terms pertinent to hypertension, diabetes, and specific stages of the care cascade. Articles published after 2011 were considered, and we included all studies that described the completion of at least one stage of the care cascade of hypertension and diabetes. Study selection was independently performed by 2 paired authors. Descriptive statistics were used to elucidate key patterns and trends. Inductive content analysis was performed to generate themes regarding the barriers and facilitators for improving the care cascade in hypertension and diabetes management. Results: A total of 128 studies were included, with 42.2% (54/128) conducted in high-income countries. Of them, 47 (36.7%) focused on hypertension care, 63 (49.2%) focused on diabetes care, and only 18 (14.1%) reported on the care of both diseases. The majority (96/128, 75.0%) were observational in design. Cascade stages documented in the literature were awareness, screening, diagnosis, linkage to care, treatment, adherence to medication, and control. Most studies focused on the stages of treatment and control, while a relative paucity of studies examined the stages before treatment initiation (76/128, 59.4% vs 52/128, 40.6%). There was a wide spectrum of interventions aimed at enhancing the hypertension and diabetes care cascade. The analysis unveiled a multitude of individual-level and system -level factors influencing the successful completion of cascade sequences in both high-income and low- and middle-income settings. Conclusions: This review offers a comprehensive understanding of hypertension and diabetes management, emphasizing the pivotal factors that impact each stage of care. Future research should focus on upstream cascade stages and context-specific interventions to optimize patient retention and care outcomes.
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页数:20
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