Effectiveness of Smartphone-Based Self-Management Interventions on Self-care and Health Relevant Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis (Preprint)

2018 ◽  
Author(s):  
Haziqah Binte Aminuddin ◽  
Nana Jiao ◽  
Ying Jiang ◽  
Jingfang Hong ◽  
Wenru Wang
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Meta Analysis ◽  
Self Care ◽  
Self Management ◽  
Significant Heterogeneity ◽  
Major Health Problem ◽  
Management Interventions

BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a major health problem worldwide. Proper self-management can improve health outcomes and reduces risk of diabetic complications. Recently, smartphone-based technology has been used for self-management programs but their effectiveness in improving self-efficacy, self-care activities, health-related quality of life (HRQoL) and clinical outcomes for patients with T2DM is not well understood. OBJECTIVE To review the evidence and determine the effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, HRQoL, glycated haemoglobin (HbA1c), body mass index (BMI), blood pressure (BP) levels of adults with T2DM. METHODS A systematic search of five databases (PubMed, Embase, Cochrane, CINAHL and Scopus) was conducted. Study published in English, from January 2007 to January 2018, were considered. Only randomised controlled trials (RCTs) of smartphone-based self-management interventions for patients with T2DM that reported any of the study outcomes were included. Two reviewers independently screened the studies, extracted data and assessed the quality of the studies. Meta-analyses were conducted for the different study outcomes. RESULTS A total of 26 articles, consisting of 22 studies with 2645 participants were included in the review. A meta-analysis conducted on self-efficacy revealed a large improvement of 0.98 (95% confidence interval [CI] 0.42 to 1.55; P < 0.001) with smartphone-based self-management interventions. The effect size on self-care activities was also large (d = 0.90; 95% CI 0.24 to 1.57; P < 0.001). Significant heterogeneity was present among studies pooled for both outcomes and subgroup analyses were conducted for self-efficacy. Smartphone-based self-management interventions also gave a small improvement on HRQoL (d = 0.26; 95% CI 0.06 to 0.47; P = .01) and a significant reduction in HbA1c (pooled MD = -0.55; 95% CI -0.60 to -0.40; P < 0.001). The effects on BMI and BP were not statistically significant. CONCLUSIONS Smartphone-based self-management interventions appear to have beneficial effects on self-efficacy, self-care activities and health-relevant outcomes for patients with T2DM. However, more research with good study designs is needed to evaluate the effectiveness of smartphone-based self-care interventions for T2DM. CLINICALTRIAL NA

scholarly journals Effectiveness of Patient-centered Care for Diabetes Self-management to Improve Glycemic Control and Self-care Behaviors in Adults With Type 2 Diabetes: a Systematic Review

2021 ◽  
Author(s):  
Kainat Asmat ◽  
Khairunnisa Dhamani ◽  
Raisa Gul ◽  
Erika Sivarajan Froelicher
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care ◽  
Self Management ◽  
Foot Care ◽  
Patient Centered ◽  
Management Interventions ◽  
Centered Care ◽  
Care Outcomes

Abstract Background: Patient-centered care in diabetes self-management might be a significant factor in improving self-care outcomes yet the supporting evidence is inadequate. This review is aimed to assess the effectiveness of patient-centered self-management care interventions on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors in adults with type-2 diabetes compared with usual care. Methods: CINAHL, PubMed, Cochrane Library, Google Scholar and the HEC Pakistan digital library were searched for English language studies that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or above with type 2 diabetes from 1991 to 2020. Interventional studies comprising randomized controlled trials (RCT) and quasi experimental studies (QES) with at least three months follow up and reporting on self-care outcomes with glycemic control (HbA1c) as primary outcome and self-care behaviors including diet control, physical activity, medication adherence and foot care as secondary outcomes were included. Results: Of the 168 identified records, 25 were found eligible comprising 21 RCTs and 4 QESs with total 4,443 participants. The meta-analysis involved 23 studies that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c −0.53 (95% CI −0.73, −0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components −0.59 (95% CI −0.86, −0.32), spanned over shorter (<03 months) duration −0.56 (95% CI −0.86, −0.27), administered by nurses −0.80 (95% CI −1.44, −0.16) and delivered in community setting −0.65 (95% CI −1.00, −0.29). Moreover, patient-centered self-management interventions were found effective in improving diet control, physical activity and foot care. Conclusion: This systematic review provided the evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing towards success.

scholarly journals Pathways Linking Health Literacy to Self-Management in People with Type 2 Diabetes

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1734
Author(s):  
Eun-Hyun Lee ◽  
Young Whee Lee ◽  
Duckhee Chae ◽  
Kwan-Woo Lee ◽  
Seongbin Hong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Literacy ◽  
Social Isolation ◽  
Indirect Effect ◽  
Self Efficacy ◽  
Self Management ◽  
Mediation Model ◽  
Cross Sectional ◽  
Management Interventions

Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.

Advanced information technologies in management of type 2 diabetes mellitus: A network meta-analysis (Preprint)

2021 ◽  
Author(s):  
Jia Zhang ◽  
Xi Liu ◽  
Liling Wei ◽  
Qiong Zeng ◽  
Kun Lin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Meta Analysis ◽  
Self Management ◽  
Cochrane Library ◽  
Common Chronic Disease ◽  
Management Interventions ◽  
Computer Based

BACKGROUND Type 2 diabetes mellitus（T2DM）is one of the most common chronic disease worldwide, and the number of people with T2DM is expected to exceed 9% of the world’s population by 2035, which puts heavy pressure on patients and the health-care system. Recently, self-management of the diabetes had been making great progress with the development of the advance technology. There were many new self-management interventions, including computer-based deliver, telephone deliver and so on. OBJECTIVE The network meta‐analysis was designed to comprehensively evaluate the efficacy of self-management for T2DM in present study. METHODS Keywords “Type 2 diabetes mellitus” and “self-management intervention” were used as searching strategies through PubMed, Cochrane library, MEDLINE, and EMBASE databases (inception–May2, 2020). The search criteria were RCT studies and reported in English language. The primary outcome was the change in HbA1c from baseline. We perform the pairwise meta-analysis and Bayesian NMA to investigate the efficacy of self-management in patients with T2DM, applying Revman 5.3, Stata 14.0 software and GeMTC 0.14.3. RESULTS Thirty-five studies met the inclusion criteria and qualified for the ultimate meta-analysis. Our meta-analysis displayed three advance self-management for T2DM, including computer-based deliver, telephone deliver and telemonitoring deliver. All of these self-management measures had been proven to be more effective than placebo in blood glucose management, and computer-based deliver is most likely to become the most efficient way among them. CONCLUSIONS Compared with other self-management, the computer-based deliver was the most effective self-management for T2DM.

scholarly journals THE INFLUENCE OF DIABETES SELF MANAGEMENT EDUCATION AND SUPPORT FOR SELF EFFICACY AND SELF CARE BEHAVIOUR IN CLIENT WITH TYPE 2 DIABETES MELLITUS

2020 ◽  
Vol 4 (1) ◽  
pp. 100-111
Author(s):  
FITRIAH FITRIAH ◽  
MUSTOFA HARIS ◽  
Mufarika Mufarika ◽  
CICILIA DESY MEGAWATI ◽  
SURYANINGSIH SURYANINGSIH ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Management Education ◽  
Self Care ◽  
Self Management ◽  
Regression Test ◽  
Logistic Regression Test

Independent diabetes care management is needed for health maintenance. Low self-care is caused by low self-efficacy. The purpose of this study was to analyze the effects of diabetes self-management education and support for self-efficacy and independent behavior in clients with type 2 diabetes mellitus. This observational research used a cross sectional approach. Sample which used clusster sampling method consisted of of 200 people. Independent variable was education and support for independent diabetes management, and dependent variable was self-efficacy and independence. Research analysis techniques used bivariate statistical logistic regression test. The results of Binary Logistic Regression test showed that education and independent management support for diabetes significantly influence self-efficacy with a result of sig 0.001 <α 0.05. Education and support for independent diabetes management significantly influence self-care with sig 0,000 <α 0,05. Self-efficacy affects self-care significantly with sig 0,000 <α 0,05. Self-management education and diabetes support are beneficial for people with type 2 diabetes in increasing self-confidence to control and manage the disease they experience. Keywords: Self-management education, self-efficacy and self-reliance behavior

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