Abstract
BackgroundAlthough several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended. The aim of this study was to identify the qualitative evidence for the challenges regarding diabetes management.MethodsA systematic review of qualitative studies following PRISMA guidelines was undertaken. Scopus, PubMed, Science Direct, and Web of Knowledge were searched as well as Persian databases including Magiran, Irandoc and SID from inception to August 2019. The included Studies were either in English- or Persian-language qualitative studies reporting the perspectives of patients, their relatives, or healthcare service providers. Content of the findings were analysed and organized according to Chronic Care Model framework.ResultsTwelve studies met the inclusion criteria. Six main themes were identified including holistic understanding of patients, leadership and governance difficulties, service delivery, workforce, financing, and information and research.ConclusionChallenges regarding the management of diabetes in Iran is multifaceted. Reforming the health care system or developing complementary strategies is essential to improve suitable health care model for patients with chronic conditions such as diabetic patients.
Highlights
Several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended
A systematic literature review and evidence synthesis of qualitative evidence on challenges of diabetes management in Iran was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [13]
Participants perceived information system failure [27] and poor records registrations [25] that act as an obsolete information technology [23]. They believed that important piece of data such as visit date or the test results are not been recorded [18]. This meta-synthesis sought to provide a comprehensive understanding of diabetes management challenges from the perspectives of the main stakeholders of diabetes care in Iran
Summary
Several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended. In Iran, as the second-largest country in the Middle East, diabetes is a major public health problem because of its high prevalence rate, increasing incident rate, and. It is well-documented that a good healthcare services and healthy life style can prevent diabetes related complications and enhance the quality of the patient’s. A nationwide prospective analysis of data for 30,202 patients found that only 13.2%of patients with diabetes achieved satisfactory glycemic control target [11]. This finding reveals challenges regarding current diabetes management in Iran
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