University of South Australia, South Australia, Australia.
Int J Evid Based Healthc. 2011 Dec;9(4):346-61. doi: 10.1111/j.1744-1609.2011.00228.x.
The objectives of this review were to establish the effectiveness of approaches to the provision of education for adults with type 1 diabetes using or initiating insulin pump therapy (IPT), and identify the best available evidence on the association between intervals and duration of follow up and the stated outcome criteria.
This review considered all studies and papers that involved adults (aged 16 years or over) with type 1 diabetes using IPT as their primary form of therapy who participated in education or training, with no restrictions placed on gender or comorbidities. All forms of education, including resources utilised during education were included in the review.
The search strategy sought to find both published and unpublished studies and papers written in the English language. An initial limited search of MEDLINE and CINAHL databases was undertaken to identify optimal search terms. A second search using all identified key words and index terms was then undertaken based on key words specific to each database across all included databases from 1998 to February 2008. Thirdly, the reference lists of all identified reports and articles were searched for additional studies.
Two independent reviewers assessed the methodological quality of retrieved papers using the corresponding checklist from the System for the Unified Management, Assessment and Review of Information (SUMARI) package.
A total of 142 studies were identified as potentially relevant to the review question in the first and second steps of the literature search. Based on the title and abstract, 24 papers that were relevant to the review topic were retrieved for evaluation of methodological quality. Following this stage, 20 papers were excluded. Whilst searching the reference lists of the selected studies (n = 4), one paper met the inclusion criteria. Therefore, a total of five descriptive studies were included in the review. The included papers reported a variety of educational methods and different outcome measures.
In general, it is difficult to draw a strong conclusion regarding the effectiveness of components and strategies associated with IPT because of a lack of high-quality comparative studies, small sample sizes and a variability of reported methods in the included studies. However, included descriptive studies explored a range of issues related to the effectiveness of IPT therapy, and the educative requirements of patients. It is clear that type 1 diabetes patients initiating and utilising IPT need a comprehensive range of advice, education and training. The mixture of group and individual teaching, multidisciplinary teams as educators, educational materials, long-term training with multiple sessions and a variety of educational contents may all be effective for delivering IPT education and training.
本综述旨在确定为使用或开始胰岛素泵治疗（IPT）的 1 型糖尿病成人提供教育的方法的有效性，并确定关于随访间隔和持续时间与既定结果标准之间关联的最佳现有证据。
本综述考虑了所有涉及使用 IPT 作为主要治疗形式的 1 型糖尿病成人（16 岁及以上）的研究和论文，这些患者参加了教育或培训，对性别或合并症没有任何限制。本综述包括所有形式的教育，包括教育过程中使用的资源。
该检索策略旨在寻找已发表和未发表的研究和论文，这些研究和论文均采用英文书写，涉及使用 IPT 作为主要治疗形式的 1 型糖尿病成人。首先对 MEDLINE 和 CINAHL 数据库进行了有限的初步搜索，以确定最佳检索词。然后，根据每个数据库的特定关键字，对所有已确定的关键字和索引术语进行了第二次搜索，检索了从 1998 年到 2008 年 2 月所有纳入数据库的报告和文章。最后，对所有已确定报告和文章的参考文献进行了搜索，以寻找其他研究。
两名独立评审员使用 SUMARI 包中的相应检查表评估检索到的论文的方法学质量。
在文献检索的第一和第二阶段，共确定了 142 项研究可能与综述问题相关。根据标题和摘要，检索了 24 篇与综述主题相关的论文，以评估其方法学质量。经过这一阶段，有 20 篇论文被排除。在检索所选研究的参考文献列表（n=4）时，有一篇论文符合纳入标准。因此，共有 5 项描述性研究被纳入综述。纳入的论文报告了各种教育方法和不同的结果测量。
一般来说，由于缺乏高质量的对照研究、样本量小以及纳入研究报告方法的变异性，很难对与 IPT 相关的组件和策略的有效性得出有力的结论。然而，纳入的描述性研究探讨了与 IPT 治疗有效性以及患者教育需求相关的一系列问题。显然，开始使用 IPT 的 1 型糖尿病患者需要全面的建议、教育和培训。小组和个人教学的结合、多学科团队作为教育者、教育材料、长期多次培训以及各种教育内容，可能都有助于提供 IPT 教育和培训。
