King's College London, The Florence Nightingale School of Nursing and Midwifery, 57 Waterloo Road, London, UK.
Diabet Med. 2010 Nov;27(11):1217-25. doi: 10.1111/j.1464-5491.2010.03113.x.
To examine the impact of telephone follow-up interventions on glycaemic control in patients with Type 2 diabetes.
This was a systematic review and meta-analysis of randomized controlled trials using The Cochrane Library, including the Cochrane central register of controlled trials; MEDLINE, EMBASE, PsycINFO and CINHAL, together with citation searching. The included studies were randomized controlled trials examining the effect of a telephone follow-up intervention on glycaemic control in patients with Type 2 diabetes. All the included trials were subject to critical appraisal. Data were extracted on study design, characteristics of patients, exact nature of the telephone intervention and details of comparison. Pooled standardized effects were calculated for the primary outcome. Glycaemic control was measured by HbA(1c) .
HbA(1c) levels reported in the reviewed studies were pooled using random effects models. The standardized effect of telephone follow-up was equivocal, with endpoint data showing weighted mean differences of -0.44 (95% CI -0.93 to 0.06) (Z = -1.72, P=0.08) in favour of the telephone follow-up intervention. Subgroup analysis of more intensive interventions (interactive follow-up with health professional plus automated follow-up or non-interactive follow-up) showed (n=1057) a significant benefit in favour of the treatment group, with a standardized mean difference of -0.84 (95% CI -1.67 to 0.0) (Z=1.97, P=0.05), indicating that more intensive (targeted) modes of follow-up may have better effects on glycaemic control.
The analysis suggested that telephone follow-up interventions following a more intensive targeted approach could have a positive impact on glycaemic control for Type 2 diabetes.
研究电话随访干预对 2 型糖尿病患者血糖控制的影响。
这是一项系统评价和荟萃分析，使用 Cochrane 图书馆、Cochrane 对照试验中心注册库、MEDLINE、EMBASE、PsycINFO 和 CINHAL 进行检索，包括随机对照试验。纳入的研究为观察电话随访干预对 2 型糖尿病患者血糖控制影响的随机对照试验。所有纳入的试验均进行了严格评价。对研究设计、患者特征、电话干预的确切性质和比较细节进行数据提取。主要结局的汇总标准化效应进行计算。血糖控制用 HbA1c 衡量。
对综述研究中报告的 HbA1c 水平采用随机效应模型进行汇总。电话随访的标准化效应不确定，终点数据显示电话随访干预组的加权平均差异为-0.44（95%CI-0.93 至 0.06）（Z=-1.72，P=0.08）。对更强化干预（与健康专业人员进行互动式随访加自动化随访或非互动式随访）的亚组分析（n=1057）显示，治疗组有显著的获益，标准化均数差为-0.84（95%CI-1.67 至 0.00）（Z=1.97，P=0.05），表明更强化（有针对性）的随访模式可能对血糖控制有更好的效果。
分析表明，更强化的靶向电话随访干预可能对 2 型糖尿病患者的血糖控制产生积极影响。
