Systematic Literature Review of the Impact of Type 2 Diabetes and Heart Failure Guideline Adherence on Clinical and Economic Outcomes.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-03-27 DOI:10.1007/s13300-025-01725-8

Elena Vianini, Anuja Pandey, Catherine Rolland, Nomxolisi Ngubane, Dirk Mueller-Wieland, Jeremy Gilbert, Alhussein Ahmad

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引用次数: 0

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is associated with comorbidities, particularly in the cardiovascular, renal, and metabolic (CVRM) spectrum. Given the complexity of CVRM spectrum diseases and the treatment landscape, treatment guidelines have been established to assist physicians in selecting the most appropriate treatment based on not only patients' primary disease but also their comorbidities. However, the impact of adherence to treatment guidelines on associated outcomes remains unclear.

Methods: A systematic literature review was conducted to evaluate the impact of guideline-based treatment on clinical, economic, and quality-of-life (QoL) outcomes and related comorbidities in the CVRM spectrum or heart failure (HF) alone in individuals with T2DM. The MEDLINE, MEDLINE In-Process, Embase, Cochrane Central Register of Controlled Trials, and EconLit electronic databases were searched to identify relevant peer-reviewed studies published in the United States, Canada, or Germany. The studies were screened and selected for inclusion or exclusion based on populations, interventions, comparators, and study design (PICOS) criteria.

Results: Of the 622 records identified, 28 publications met the inclusion criteria. In total, 11 and 16 studies reported adherence to clinical guidelines for T2DM and HF management, respectively. Adherence to T2DM and HF treatment guidelines decreased all-cause mortality and all-cause hospitalizations; furthermore, adherence to T2DM guidelines decreased hospitalizations due to HF, myocardial infarction, and stroke, and reduced T2DM-related long-term complications, while adherence to HF guidelines reduced hospitalizations due to HF. Evidence gaps were identified, including the need to assess the impact of guideline adherence on economic outcomes, the impact of adherence to diagnosis and monitoring guidelines, and the impact of guideline adherence on QoL outcomes.

Conclusions: Adherence to disease management guidelines improves the outcomes of patients with T2DM or HF and reduces disease-related complications and hospitalizations; however, key evidence gaps exist, particularly regarding patients with T2DM along with comorbidities in the CVRM spectrum.

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2型糖尿病和心力衰竭指南依从性对临床和经济结果影响的系统文献综述。

2型糖尿病（T2DM）与合并症相关，特别是在心血管、肾脏和代谢（CVRM）方面。考虑到crvrm谱系疾病的复杂性和治疗前景，已经建立了治疗指南，以帮助医生根据患者的原发疾病和合并症选择最合适的治疗方法。然而，遵守治疗指南对相关结果的影响尚不清楚。方法：通过系统的文献综述，评估基于指南的治疗对T2DM患者临床、经济、生活质量（QoL）结果和相关合并症（crvrm谱或心力衰竭（HF））的影响。检索MEDLINE、MEDLINE in - process、Embase、Cochrane Central Register of Controlled Trials和EconLit电子数据库，以确定发表在美国、加拿大或德国的相关同行评议研究。根据人群、干预措施、比较物和研究设计（PICOS）标准筛选和选择纳入或排除研究。结果：在确定的622篇文献中，28篇文献符合纳入标准。总共有11项和16项研究分别报告了T2DM和HF管理的临床指南依从性。坚持T2DM和HF治疗指南降低了全因死亡率和全因住院率；此外，遵守T2DM指南减少了因HF、心肌梗死和卒中引起的住院，并减少了T2DM相关的长期并发症，而遵守HF指南减少了因HF引起的住院。发现了证据差距，包括需要评估指南依从性对经济结果的影响，对诊断和监测指南的依从性的影响，以及指南依从性对生活质量结果的影响。结论：遵守疾病管理指南可改善T2DM或HF患者的预后，减少疾病相关并发症和住院治疗；然而，存在关键的证据差距，特别是关于T2DM患者以及crvrm谱系的合并症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.