评估远程医疗对糖尿病患者血糖管理的影响:随机对照试验的系统回顾和荟萃分析

IF 3.3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES BMC Health Services Research Pub Date : 2025-02-20 DOI:10.1186/s12913-025-12401-9
Addisu Getie, Baye Tsegaye Amlak, Temesgen Ayenew, Mihretie Gedfew
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摘要

导言:糖尿病(DM),特别是2型糖尿病的患病率日益增加,对医疗保健系统提出了重大挑战。有效的血糖管理对于预防严重并发症至关重要,远程医疗为提高患者参与度和依从性提供了一种有希望的方法。应调查远程医疗对血糖管理的有效性。在本研究中,糖尿病管理计划的评估指标是血糖水平的变化,特别是HbA1c,作为血糖控制的指标。在不同的患者群体中分析了远程医疗干预对这些结果的影响。本综述对当前文献进行了全面的分析,以提供能够指导临床实践的见解,并告知决策者远程医疗在管理糖尿病方面的优势。方法:在本研究中,检索了多个循证数据库和相关临床试验注册库,以评估远程医疗对糖尿病患者血糖管理的影响。纳入的研究是随机对照试验,比较远程医疗与传统的现场管理。在导出到STATA/MP 17.0进行分析之前,使用Microsoft Excel对数据进行提取和排序。采用加权反方差随机效应模型,置信区间为95%。采用Egger检验和Cochrane I2统计分别评估发表偏倚和异质性。结果:本综述确定了6项随机对照试验(rct),共涉及3,995例患者,其中远程医疗干预组2,022例,对照组1,973例,在美国、亚洲和欧洲进行。分析显示,使用远程医疗的患者血糖控制有显著改善,标准平均差异(SMD)为0.20 (95% CI: 0.10-0.29;结论与建议:本研究表明远程医疗干预可显著提高糖尿病患者的血糖管理水平。研究结果强调,卫生保健系统需要优先将远程医疗纳入糖尿病管理方案,同时制定量身定制的干预措施,以满足不同患者群体的不同需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Assessing the impact of telehealth on blood glucose management among patients with diabetes: a systematic review and meta-analysis of randomized controlled trials.

Introduction: The increasing prevalence of diabetes mellites (DM), especially type 2 diabetes mellitus, presents significant challenges for healthcare systems. Effective blood glucose management is essential for preventing serious complications, and telehealth offers a promising approach to improve patient engagement and adherence. The effectiveness of telehealth on blood glucose management should be investigated. The evaluated metric for diabetes management plans in this study was the change in blood glucose levels, specifically HbA1c, as an indicator of glycemic control. The impact of telehealth interventions on these outcomes was analyzed across various patient groups. This review conducts a comprehensive analysis of the current literature to offer insights that can guide clinical practices and inform policymakers about the advantages of telehealth in managing diabetes.

Methods: In this study, several evidence-based databases and relevant clinical trial registries were searched to evaluate the effects of telehealth on blood glucose management among patients with diabetes. The included studies were randomized controlled trials that compared telehealth with traditional in-person management. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess publication bias and heterogeneity, respectively.

Result: This review identified six randomized controlled trials (RCTs) involving a total of 3,995 patients, with 2,022 in the telehealth intervention group and 1,973 in the control group, conducted across the USA, Asia, and Europe. The analysis showed a significant improvement in blood glucose control for patients using telehealth, evidenced by a Standard Mean Difference (SMD) of 0.20 (95% CI: 0.10-0.29; p < 0.001), with USA studies reflecting the highest SMD of 0.24 and diabetic veterans showing an even greater SMD of 0.41.

Conclusion and recommendations: This study demonstrates that telehealth interventions significantly enhance blood glucose management among patients with diabetes. The findings highlight the need for healthcare systems to prioritize telehealth integration into diabetes management protocols while developing tailored interventions to meet the diverse needs of various patient populations.

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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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