Toggle Main Menu Toggle Search

Open Access padlockePrints

Interventions developed to reduce secondary care utilisation in patients with type 2 diabetes mellitus: a narrative review

Lookup NU author(s): Sarah Khayyat, Dr Philippa Walters, Dr Hamde Nazar


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


© The Author(s) 2022. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: To identify, describe and critically appraise the quality of studies of interventions developed to reduce the rate of secondary care utilisation and investigate interventions' impact on patients with type 2 diabetes mellitus (T2DM). METHOD: Using a systematic approach, five databases were searched between 01 January 1995 and 01 February 2021 (MEDLINE, EMBASE, PsycINFO, CINAHL and Cochrane database). Inclusion criteria were studies (published in English) in adults with T2DM offered intervention(s) involving medicines/services/educational programmes in any country or setting, with investigated outcomes including the rate of hospital admission/re-admission/accident and emergency visits. Validated tools were used to assess the quality and accuracy of reporting the interventions. A narrative synthesis was used to frame the findings. KEY FINDINGS: A total of 4670 papers were identified, which yielded a final 53 studies after screening against the inclusion criteria. Identified interventions were complex interventions (n = 21) including at least two interventions (e.g. improving medication adherence and patient education), medication management (n = 15), patient education programmes (n = 8), lifestyle interventions (n = 5) and other interventions (n = 4; e.g. dental care). After assessing for quality and effectiveness of interventions, 15 studies remained; 7 were medication management interventions (e.g. use of insulin pen) and 8 were complex interventions (e.g. pharmaceutical care and telehealth systems). Complex interventions showed significant improvement in clinical outcomes and reduction in secondary care utilisation. CONCLUSIONS: This narrative review identified potential elements of an effective complex intervention to reduce healthcare utilisation in patients with T2DM. These results could inform the development of interventions to be tested for feasibility, before piloting to assess for outcomes that improve diabetic care, reduce diabetes-related complications and minimise healthcare utilisation.

Publication metadata

Author(s): Khayyat SM, Walters PA, Whittlesea C, Nazar H

Publication type: Review

Publication status: Published

Journal: The International Journal of Pharmacy Practice

Year: 2022

Volume: 30

Issue: 2

Pages: 116-128

Print publication date: 26/05/2022

Online publication date: 18/04/2022

Acceptance date: 02/02/2022

ISSN (print): 0961-7671

ISSN (electronic): 2042-7174

Publisher: NLM (Medline)


DOI: 10.1093/ijpp/riac009

PubMed id: 35435983