Primary health care interventions targeting diabetes, hypertension or dyslipidemia in Malaysia: A scoping review

Abstract

Introduction Despite the high prevalence of diabetes, hypertension and dyslipidemia among Malaysian adults, there are gaps in management and control of these diseases. Evidence suggests that implementation of the Chronic Care Model in primary health care (PHC) can improve patients’ clinical outcomes, quality of life and reduce the overall social burden. This study aims to describe the PHC interventions for diabetes, hypertension and/or dyslipidemia in Malaysia and to identify existing gaps by mapping against Chronic Care Model domains. Methods This study reports a section of a larger scoping review and focuses on studies with interventions. PubMed, Embase, Scopus and MyMedR were searched systematically from inception until 31 December 2024, using keywords pertaining to “diabetes”, “hypertension”, “dyslipidemia”, “PHC” and “Malaysia”. Study selection was independently performed by reviewers in pairs. Results A total of 32 interventions were identified across 39 publications. The earliest study was published in 2012 and the highest number of publications was seen in 2020. Most studies were conducted in the states of Kelantan and Selangor. The two most common components of intervention were patient education (n = 16) and the use of decision aids (n = 11). Interventions predominantly targeted type 2 diabetes (72%) and the Chronic Care Model domains of self-management support and delivery system design, with very few addressing community linkages (n = 3). Intermediate clinical outcomes (HbA1c, blood pressure, and cholesterol) were the most common measures. Discussion/conclusions This review highlights key gaps in PHC interventions for these three chronic diseases. While self-management and delivery systems are well-addressed, current efforts remain heavily focused on individuals with diabetes, with limited attention to community components and rural populations. There is a need to broaden the intervention scope beyond diabetes and invest in stronger community linkages for a more equitable system in Malaysia.