QUALITY INDICATORS FOR DIABETES MELLITUS: A RAPID EVIDENCE SYNTHESIS

Received 2023-07-06; Accepted 2023-12-07; Published 2024-08-01

Abstract

Diabetes is a serious public health problem in Malaysia with the prevalence of type 2 diabetes at 18.3% among adults above the age of 18, affecting 3.9 million individuals as reported by NHMS (2019). Monitoring of diabetes necessitates a set of quality measures comparable with other countries; thus, identifying meaningful indicators is pivotal. This rapid review aimed to identify the quality of care indicators for adults with type 2 diabetes across the continuum of care. A comprehensive MEDLINE search was conducted using PubMed for relevant studies. This search was supplemented by an examination of relevant government and international organisation websites. Records were included if the paper had quality indicators, complete with its numerator and denominator. Non-English articles
were excluded. Records were screened and data were extracted into a pre-determined data extraction form. We found 130 records using various search techniques. A total of 27 records were eligible to be included for analysis. The collected indicators were then classified using Donabedian’s structure-process-outcome framework, and assigned to six diabetes care categories. The final list of diabetes quality indicators included 65 indicators, with 69% of them being process indicators, 29% outcome indicators and only 2% structure indicators. Two diabetes care categories with the highest number of indicators were risk factors for diabetes complication (n = 14, 22%) and diabetes education (n = 12, 18%). This review aided the establishment of an inventory of international diabetes quality indicators,
complete with numerators and denominators, focusing on different aspects of diabetes monitoring across quality domains and levels of health care. This may facilitate our relevant stakeholders in indicator selections, adoption and adaptation in the local context.