TY - JOUR
T1 - Digital interventions self-management education for type 1 and 2 diabetes
T2 - A systematic review and meta-analysis
AU - Nkhoma, Dumisani Enricho
AU - Soko, Charles Jenya
AU - Bowrin, Pierre
AU - Manga, Yankuba B.
AU - Greenfield, David
AU - Househ, Mowafa
AU - Li, Yu-Chuan
AU - Iqbal, Usman
N1 - Funding Information:
This work was supported in part by Ministry of Science and Technology (MOST), Taiwan under grant MOST110-2221-E-038-020 .
Publisher Copyright:
© 2021
PY - 2021/10
Y1 - 2021/10
N2 - Objective: To describe and assess digital health-led diabetes self-management education and support (DSMES) effectiveness in improving glycosylated hemoglobin, diabetes knowledge, and health-related quality of life (HrQoL) of Type 1 and 2 Diabetes in the past 10 years. Design: Systematic Review and Meta-Analysis. The protocol was registered on PROSPERO registration number CRD42019139884. Data Sources: PubMed, EMBASE, Cochrane library, Web of Science, and Scopus between January 2010 and August 2019. Study Selection and Appraisal: Randomized control trials of digital health-led DSMES for Type 1 (T1DM) or 2 (T2DM) diabetes compared to usual care were included. Outcomes were change in HbA1c, diabetes knowledge, and HrQoL. Cochrane Risk of Bias 2.0 tool was used to assess bias and GRADEpro for overall quality. The analysis involved narrative synthesis, subgroup and pooled meta-analyses. Results: From 4286 articles, 39 studies (6861 participants) were included. Mean age was 51.62 years, range (13–70). Meta-analysis revealed intervention effects on HbA1c for T2DM with difference in means (MD) from baseline -0.480% (-0.661, -0.299), I275% (6 months), -0.457% (-0.761, -0.151), I2 81% (12 months), and for T1DM -0.41% (-1.022, 0.208) I2 83% (6 months), -0.03% (-0.210, 0.142) I2 0% (12 months). Few reported HrQoL with Hedges’ g 0.183 (-0.039, 0.405), I2 0% (6 months), 0.153 (-0.060, 0.366), I2 0% (12 months) and diabetes knowledge with Hedges’ g 1.003 (0.068, 1.938), I2 87% (3 months). Conclusion: Digital health-led DSMES are effective in improving HbA1c and diabetes knowledge, notably for T2DM. Research shows non-significant changes in HrQoL. Intervention effect on HbA1c was more impressive if delivered through mobile apps or patient portals. Further research is needed on the impact of DSMES on these outcomes, especially for newly diagnosed diabetes patients.
AB - Objective: To describe and assess digital health-led diabetes self-management education and support (DSMES) effectiveness in improving glycosylated hemoglobin, diabetes knowledge, and health-related quality of life (HrQoL) of Type 1 and 2 Diabetes in the past 10 years. Design: Systematic Review and Meta-Analysis. The protocol was registered on PROSPERO registration number CRD42019139884. Data Sources: PubMed, EMBASE, Cochrane library, Web of Science, and Scopus between January 2010 and August 2019. Study Selection and Appraisal: Randomized control trials of digital health-led DSMES for Type 1 (T1DM) or 2 (T2DM) diabetes compared to usual care were included. Outcomes were change in HbA1c, diabetes knowledge, and HrQoL. Cochrane Risk of Bias 2.0 tool was used to assess bias and GRADEpro for overall quality. The analysis involved narrative synthesis, subgroup and pooled meta-analyses. Results: From 4286 articles, 39 studies (6861 participants) were included. Mean age was 51.62 years, range (13–70). Meta-analysis revealed intervention effects on HbA1c for T2DM with difference in means (MD) from baseline -0.480% (-0.661, -0.299), I275% (6 months), -0.457% (-0.761, -0.151), I2 81% (12 months), and for T1DM -0.41% (-1.022, 0.208) I2 83% (6 months), -0.03% (-0.210, 0.142) I2 0% (12 months). Few reported HrQoL with Hedges’ g 0.183 (-0.039, 0.405), I2 0% (6 months), 0.153 (-0.060, 0.366), I2 0% (12 months) and diabetes knowledge with Hedges’ g 1.003 (0.068, 1.938), I2 87% (3 months). Conclusion: Digital health-led DSMES are effective in improving HbA1c and diabetes knowledge, notably for T2DM. Research shows non-significant changes in HrQoL. Intervention effect on HbA1c was more impressive if delivered through mobile apps or patient portals. Further research is needed on the impact of DSMES on these outcomes, especially for newly diagnosed diabetes patients.
KW - Diabetes mellitus
KW - Diabetes self-management education and support
KW - Digital health
KW - E-health
KW - Global health
KW - Health promotion
KW - Mobile health
KW - Patient Education
KW - Social media
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U2 - 10.1016/j.cmpb.2021.106370
DO - 10.1016/j.cmpb.2021.106370
M3 - Article
C2 - 34492544
AN - SCOPUS:85114252143
SN - 0169-2607
VL - 210
JO - Computer Methods and Programs in Biomedicine
JF - Computer Methods and Programs in Biomedicine
M1 - 106370
ER -