Organisational initiatives to improve care in the prevention and management of cardiometabolic conditions: A scoping review

Aim: Cardiometabolic conditions such as cardiovascular disease, type 2 diabetes, and chronic kidney disease contribute to multimorbidity, posing a global health challenge. However, existing healthcare frameworks often struggle to adequately address the intricate needs of individuals living with these conditions. The review aims to map existing research on cardiometabolic care initiatives for the primary and secondary prevention of metabolic conditions.

Data synthesis: A scoping review was conducted following the methodology of the Joanna-Briggs-Institute. We searched Medline, Embase, and CINAHL. The review primarily sought studies comparing the effectiveness of cardiometabolic services/clinics in primary or secondary prevention of cardiometabolic conditions with standard care. The data from these studies were charted and summarised in tabular form, with a narrative synthesis. The search identified 97 records across three databases, and 18 documents met inclusion criteria. Two studies addressed cardiometabolic care in primary prevention, while twelve focused on secondary prevention. Positive outcomes were observed in primary prevention, including reductions in waist circumference, body mass index, blood pressure, and cholesterol levels. For secondary prevention, the studies demonstrated positive metabolic outcomes, such as reductions in HbA1c, weight, blood pressure, and cholesterol levels. Additionally, data from the available studies reported improved adherence to diabetes care processes and the implementation of guideline-directed therapies.

Conclusion: This scoping review highlights the potential benefits of services such as cardiometabolic clinics for primary and secondary prevention in metabolic conditions. Future studies should use standardised outcome measures and include details on the structure, staffing and treatment intensity of clinics to aid their wider implementation.