Reference and study design | Topic | Main results |
Barceló et al
31 Cluster RCT | Diabetes care | QIC sites increased foot (p<0.01) and eye examinations (p<0.01) the proportion of patients reaching three or more treatment goals (p<0.01), HbA1c control (p<0.01), TC<200 mg/dL (p<0.01) but no difference in BP control. |
Homer et al
36 Cluster RCT | Asthma care | No statistical significant differences found |
Shaw et al
39 Cluster RCT | Colorectal cancer screening | No statistical significant differences found |
Asch et al
40 CBA | Chronic heart failure | QIC sites showed greater improvement in 11 of 23 indicators, achieving 17% versus 1% improvement in composite process bundle (p<0.0001). No statistical significant differences for patient outcomes. |
Benedetti et al
42 CBA | Diabetes care | QIC sites showed greater improvement in 7 of 12 diabetes indicators (p<0.05). |
Franx et al
23 CBA | Antidepressant prescribing | Antidepressant prescription rates decreased in QIC sites by 23% versus no decrease (OR 0.44; 0.21–0.92) control sites. |
Haggstrom et al
45 CBA | Implementation of chronic care model | Overall improvement in CCM model implementation (p=0.002) |
Landon et al
49 CBA | HIV care | No statistical significant differences |
Landon et al
48 CBA | Diabetes, asthma or hypertension | For all three conditions, compared with external and internal control sites, QIC sites reported 4.5% and 4.9% improvements, respectively (p<0.001). By condition, asthma and diabetes care but not hypertension significantly improved. No statistical significant differences for patient outcomes. |
Mangione-Smith et al
51 Schonlau et al 54 CBA | Asthma care | QIC sites improved composite paediatric process score 13% versus 0% (p<0.0001) and two of five self-management indicators. QIC sites improved composite adult process score 10% versus 1% (p=0.003) and one of six self-management indicators. 2 of 9 paediatric outcomes statistically significant and 1 of 5 adult outcomes statistically significant |
Margolis et al
52 CBA | Practice delivery systems | Mean number of care delivery systems increased from 12.9 (SD 4.6) to 19.4 (SD 3.87) in QIC group with no change for controls. No statistical significant difference for composite quality indicator (four aspects of parental reported care). RR 1.25; 0.93–1.75 |
Peterson et al
61 CBA | Diabetes care | QIC practices reduced mean HbA1c −3.7 mmol/mol versus −1.7 mmol/mol (p<0.001). |
Powell et al
53 CBA | Follow-up positive colorectal cancer screening test | QIC sites increased 60-day follow-up colonoscopy from 27% to 39% versus control site decrease from 45% to 29% (p<0.02). Mean days to colonoscopy decreased for QIC sites from 129 to 103 days and increased for control sites from 81 to 103 days (p=0.001). Differences in 1-year follow-up not statistically significant. |
Schouten et al
29 CBA | Diabetes care | QIC sites improved 4 of 19 process measures; dietitian visit (17.8% vs 9.9%, p<0.01); glucose monitoring advice (61.7% vs 55.8%, p<0.05); advice to examine feet (75.2% vs 69.4%, p<0.05); instruction on foot examination (66% vs 59.5%, p<0.05) and improved 2 of 9 patient outcomes; mean SBP 139.3 (SD 17.4) versus 141.8 (SD 16.5), p<0.05; mean HDL 14.4 (SD 0.4) versus 1.3 (SD 0.4). |
Vernacchio et al
55 CBA | Asthma care | Asthma exacerbations declined greater than controls but not statistically significant. |
Youngleson et al
69 ITS with control sites | Mother-to-child HIV transmission | HIV-exposed infants testing positive declined from 7.6% to 5%. Antenatal AZT increased from 74% to 86%. Intrapartum AZT increased from 43% to 84% and HAART from 10% to 25%. Postnatal HIV testing increased from 79% to 95%. |
Crandall et al
72 ITS | Inflammatory bowel disease | Crohn’s disease (CD) and ulcerative colitis (UC), completion of assessment bundle (CD 55%–93%; UC 62%–89%, p<0.01). TPMT measure (CD 60%–80%; UC 50%–73%, p<0.01). Appropriate thiopurine dose (CD 48%–56% not statistically significant; UC 23%–64%, p<0.01). Remission (CD 55%–68%; UC 61%–72%). Steroid-free treatment (CD 86%–90%; UC, unchanged). No change in nutritional status or growth |
Patel et al
80 ITS | Bloodstream infections (BSI) | Mean BSI and access-related BSI rates reduced from 1.09 and 0.73 events/100 patient-months to 0.89 and 0.42 events/100 patient-months. Modelled BSI rates decreased 32% (p=0.01) and 54% (p=0.001) for access-related BSI. |
Pierce-Bulger et al
81 ITS | Infant mortality | 50% reduction in infant mortality with days between infant deaths increasing from mean 100 days to over 300 days |
Webster et al
89 ITS | HIV care | HAART initiations increased from 179/month (SD 17.2) to 511/month (SD 44.9); a 185% increase. |
AZT, azidothymidine; BP, blood pressure; CBA, controlled before-after study; CCM, chronic care model; HAART, highly active antiretroviral treatment; HDL, high-density lipoprotein; ITS, interrupted time series study; QIC, quality improvement collaborative; RCT, randomised controlled trial; RR, relative risk; SBP, systolic blood pressure; TC, total cholesterol; TPMT, thiopurine methyltransferase.