Dataset Information

Telemedicine interventions in type 2 diabetes management: a protocol for systematic review and network meta-analysis.

ABSTRACT:

Introduction

The consequences of type 2 diabetes mellitus (T2DM) heavily strain individuals and healthcare systems worldwide. Interventions via telemedicine have become a potential tactic to tackle the difficulties in effectively managing T2DM. However, more research is needed to determine how telemedicine interventions affect T2DM management. This study sets out to systematically analyse and report the effects of telemedicine treatments on T2DM management to gain essential insights into the potential of telemedicine as a cutting-edge strategy to improve the outcomes and care delivery for people with T2DM.

Methods and analysis

To uncover relevant research, we will perform a comprehensive literature search across six databases (PubMed, IEEE, EMBASE, Web of Science, Google Scholar and Cochrane Library). Each piece of data will be extracted separately, and any discrepancies will be worked out through discussion or by a third reviewer. The studies included are randomised controlled trial. We chose by predefined inclusion standards. After the telemedicine intervention, glycated haemoglobin will be the primary outcome. The Cochrane risk-of-bias approach will be used to evaluate the quality of the included studies. RevMan V.5.3.5 software and RStiduo V.4.3.1 software can be used to analyse the data, including publication bias.

Ethics and dissemination

Since this research will employ publicly accessible documents, ethical approval is unnecessary. The review is registered prospectively on the PROSPERO database. The study's findings will be published in a peer-reviewed journal.

Prospero registration number

CRD42023421719.

SUBMITTER: Maaitah W

PROVIDER: S-EPMC10884257 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Telemedicine interventions in type 2 diabetes management: a protocol for systematic review and network meta-analysis.

Maaitah Wasan W Abdelhay Osama O Tourkmani Ayla A Azzeh Mohammad M Abu-Soud Mohammad S MS Atiani Serin S

BMJ open 20240222 2

<h4>Introduction</h4>The consequences of type 2 diabetes mellitus (T2DM) heavily strain individuals and healthcare systems worldwide. Interventions via telemedicine have become a potential tactic to tackle the difficulties in effectively managing T2DM. However, more research is needed to determine how telemedicine interventions affect T2DM management. This study sets out to systematically analyse and report the effects of telemedicine treatments on T2DM management to gain essential insights into ...[more]

PMID: 38388501

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Project description:BackgroundDiabetes mellitus (DM) is one of the world's greatest health threats with rising prevalence. Global digitalization leads to new digital approaches in diabetes management, such as telemedical interventions. Telemedicine, which is the use of information and communication technologies, may provide medical services over spatial distances to improve clinical patient outcomes by increasing access to diabetes care and medical information.ObjectiveThis study aims to examine whether telemedical interventions effectively improve diabetes control using studies that pooled patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), and whether the benefits are greater in patients diagnosed with T2DM than in those diagnosed with T1DM. We analyzed the primary outcome glycated hemoglobin A1c (HbA1c) and the secondary outcomes fasting blood glucose (FBG), blood pressure (BP), body weight, BMI, quality of life (QoL), cost, and time saving.MethodsPublications were systematically identified by searching Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, Embase, and CINAHL databases for studies published between January 2008 and April 2020, considering systematic reviews (SRs), meta-analyses (MAs), randomized controlled trials (RCTs), and clinical trials (CTs). Study quality was assessed using the A Measurement Tool to Assess Systematic Reviews, Effective Public Health Practice Project, and National Institute for Health and Care Excellence qualitative checklist. We organized the trials by communication technologies in real-time video or audio interventions, asynchronous interventions, and combined interventions (synchronous and asynchronous communication).ResultsFrom 1116 unique citations, we identified 31 eligible studies (n=15 high, n=14 moderate, n=1 weak, and n=1 critically low quality). We selected 21 SRs and MAs, 8 RCTs, 1 non-RCT, and 1 qualitative study. Of the 10 trials, 3 were categorized as real-time video, 1 as real-time video and audio, 4 as asynchronous, and 2 as combined intervention. Significant decline in HbA1c levels based on pooled T1DM and T2DM patients data ranged from -0.22% weighted mean difference (WMD; 95% CI -0.28 to -0.15; P<.001) to -0.64% mean difference (95% CI -1.01 to -0.26; P<.001). The intervention effect on lowering HbA1c values might be significantly smaller for patients with T1DM than for patients with T2DM. Evidence on the impact on BP, body weight, FBG, cost effectiveness, and time saving was smaller compared with HbA1c but indicated potential in some publications.ConclusionsTelemedical interventions might be clinically effective in improving diabetes control overall, and they might significantly improve HbA1c concentrations. Patients with T2DM could benefit more than patients with T1DM regarding lowering HbA1c levels. Further studies with longer duration and larger cohorts are necessary.

Project description:IntroductionOptimal adherence to recommended diets is crucial to achieving long-term glycaemic control among individuals with type 2 diabetes (T2D) individuals. However, there is limited evidence on the effectiveness of interventions that target dietary adherence through social networks. Since social networks can influence individuals' health behaviours, it is important to thoroughly evaluate the impact of social network interventions on dietary adherence in adults with T2D. This systematic review protocol aimed to provide insights into future interventions and improve diabetes management strategies.Method and analysisPubMed, Embase, CINAHL Complete, Cochrane Central Register of Controlled Trials, ProQuest Dissertations and Theses and Google Scholar will be searched from inception to December 2023 for relevant randomised and non-randomised controlled trials of at least 3 months' duration. In addition, studies that compared interventions involving the social networks (families, friends and peers) of adults with T2D with usual care, no intervention or an intervention with no explicit social network component will be included. Two reviewers will independently screen search outputs according to inclusion and exclusion criteria, critically evaluate the selected literature and extract data on the study setting, design, participants' characteristics, interventions, controls, social network functions and duration of follow-up, using a standard data extraction form. Quantitative data analysis will be performed where studies are homogeneous in characteristics and provide adequate outcome data for meta-analysis. Otherwise, data will be synthesised using narrative synthesis. Finally, trials will be assessed for bias risk and overall evidence certainty using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.Ethics and disseminationEthical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publications.Prospero registration numberCRD42023441223.

Project description:BackgroundTelemedicine is often suggested as a promising approach to support patients with diabetes. However, the effectiveness of diabetes-related telemedicine interventions in regard to patient-related outcomes requires further evaluation. Previous systematic reviews describing the effectiveness of telemedicine in diabetes management focus on a specific type of telemedicine, a specific type of diabetes, specific comparators, or specific outcomes. Moreover, the rapid development within telemedicine emphasizes the need for a new review.ObjectiveThe present review has a broad scope with an eye to performing an updated and exhaustive review within the field. The review aims to evaluate the effectiveness of existing telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with diabetes.MethodsThe review will consider studies that include adult subjects with a diagnosis of diabetes (type 1, 2, or gestational), studies that evaluate various types of telemedicine interventions, and randomized controlled trials comparing a telemedicine intervention to any control that does not include telemedicine. Peer-reviewed full-text papers in English, Norwegian, Danish, and Swedish will be considered. A thorough search will be performed in the PubMed, CINAHL, EMBASE, and Cochrane Library Central Register of Controlled Trials (CENTRAL) databases. Data extraction will include details about the populations, study methods, interventions, and outcomes of significance based on the review objective.ResultsThe results of the review are expected to provide an estimate of the treatment effect. The studies will be pooled via statistical meta-analysis and supplemented with narrative comparisons when necessary.ConclusionsThe review is important as it will inform clinicians and investigators about the effect of various telemedicine solutions within the field of diabetes.International registered report identifier (irrid)DERR1-10.2196/22062.

Project description:BackgroundThe proliferation of digital technology has the potential to transform diabetes management. One of the critical aspects of modern diabetes management remains the achievement of glycemic targets to avoid acute and long-term complications.ObjectiveThis study aims to describe the landscape of evidence pertaining to the relative effectiveness or efficacy and safety of various digital interventions for the self-management of type 2 diabetes mellitus (T2DM), with a primary focus on reducing glycated hemoglobin A1c (HbA1c) levels.MethodsA systematic literature review (SLR) was conducted by searching Embase, MEDLINE, and CENTRAL on April 5, 2022. Study selection, data extraction, and quality assessment were performed by 2 independent reviewers. Eligibility criteria for the SLR included randomized controlled trials (RCTs) and comparative observational studies evaluating interventions containing both human (eg, coaching) and digital components (eg, glucose meter) in adult patients with T2DM. The primary meta-analysis was restricted to studies that reported laboratory-measured HbA1c. In secondary analyses, meta-regression was performed with the intensity of coaching in the digital intervention as a categorical covariate.ResultsIn total, 28 studies were included in this analysis. Most studies (23/28, 82%) used the reduction of HbA1c levels as the primary end point, either directly or as a part of a multicomponent outcome. In total, 21 studies reported statistically significant results with this primary end point. When stratified into 3 intervention categories by the intensity of the intervention supporting the digital health technology (analyzing all 28 studies), the success rate appeared to be proportional to the coaching intensity (ie, higher-intensity studies reported higher success rates). When the analysis was restricted to RCTs using the comparative improvement of HbA1c levels, the effectiveness of the interventions was less clear. Only half (12/23, 52%) of the included RCTs reported statistically significant results. The meta-analyses were broadly aligned with the results of the SLR. The primary analysis estimated a greater reduction in HbA1c associated with digital interventions compared with usual care (-0.31%, 95% CI -0.45% to -0.16%; P<.001). Meta-regression estimated reductions of -0.45% (95% CI -0.81% to -0.09%; P=.02), -0.29% (95% CI -0.48% to -0.11%; P=.003), and -0.28% (95% CI -0.65% to 0.09%; P=.20) associated with high-, medium-, and low-intensity interventions, respectively.ConclusionsThese findings suggest that reducing HbA1c levels in individuals with T2DM with the help of digital interventions is feasible, effective, and acceptable. One common feature of effective digital health interventions was the availability of timely and responsive personalized coaching by a dedicated health care professional.

Dataset Information

Telemedicine interventions in type 2 diabetes management: a protocol for systematic review and network meta-analysis.

Introduction

Methods and analysis

Ethics and dissemination

Prospero registration number

Publications

Telemedicine interventions in type 2 diabetes management: a protocol for systematic review and network meta-analysis.

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