Current Diabetes Reviews     Send Orders for Reprints to reprints@benthamscience.net Current Diabetes Reviews, 2021, 17, 317-331 317 SYSTEMATIC REVIEW ARTICLE The Patient-centered Medical Home as an Intervention Strategy for Dia- betes Mellitus: A Systematic Review of the Literature 1875-6417/21 $65.00+.00 © 2021 Bentham Science Publishers Lisa S. McManus 1 , Karen A. Dominguez-Cancino 2,3 , Michele K. Stanek 4 , Juan. M. Leyva- Moral 3,5,6 , Carola E. Bravo-Tare 3 , Oriana Rivera-Lozada 3,7 and Patrick A. Palmieri 1,3,6,7,8,* 1 College of Nursing, Walden University, Minneapolis, United States; 2 Escuela de Enfermería, Universidad Científica del Sur, Lima, Peru; 3 Evidence-Based Health Care South America: A Joanna Briggs Institute Affiliated Group, Lima, Peru; 4 Family & Preventive Medicine, School of Medicine, University of South Carolina, Columbia, United States; 5 De- partment d'Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; 6 Center for Glob- al Nursing, Texas Woman’s University, Houston, United States; 7 Vicerrectorado de Investigación, Universidad Nor- bert Wiener, Lima, Peru; 8 College of Graduate Health Studies, A. T. Still University, Kirksville, United States ARTICLE HISTORY Received: June 28, 2020 Revised: October 09, 2020 Accepted: October 16, 2020 DOI: 10.2174/1573399816666201123103835 Abstract: Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impacts health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering team-based care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in deliv- ering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes. Objective: The study reviews the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understands the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health-related outcomes. Methods: The systematic review was performed according to the Cochrane method and the Pre- ferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systemati- cally searched for articles. The Oxford Centre for Evidence-based Medicine Levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies. Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care manage- ment resulted in more screenings and better preventive care. Pharmacy-led interventions and tech- nology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions. Conclusion: The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as univer- sal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes. Keywords: Patient-centered medical home, diabetes, teamwork, care coordination, multidisciplinary, communication. 1. INTRODUCTION Throughout the world, chronic diseases are the leading cause of death, disability, and health care expense [1]. Imp- *Address correspondence to this author at the Vicerrectorado de Investiga- ción, Universidad Norbert Wiener, Avenida Arequipa 440, Torre 2, Piso 4, Lima, 15046, Perú; E-mails: patrick.palmieri@uwiener.edu.pe, patrick.palmieriauthor@jbisa.org pacting more than 460 million adults worldwide [2], dia- betes is expected to rise to 578 million by 2030 and 700 mil- lion by 2045 [3]. Diabetes is responsible for two-thirds of deaths [4] and more than 10% of all health care expenses [5]. The majority of these expenses are related to complica- tions associated with diabetes, including retinopathy, nephro- pathy, heart disease, and renal insufficiency [6]. However, nontraumatic limb amputations are the leading complica-