Saffari Mohsen, Ghanizadeh Ghader, Koenig Harold G
Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Prim Care Diabetes. 2014 Dec;8(4):275-85. doi: 10.1016/j.pcd.2014.03.004. Epub 2014 Apr 29.
Diabetes type 2 is an increasing problem worldwide that may be managed through education. Text-messaging using a cell phone can assist with self-care. The aim of this study was to systematically review the impact of education through mobile text-messaging on glycemic control.
The design was a systematic review with meta-analysis. Five electronic databases were searched to access English studies involving a randomized controlled trial design that used text-messaging educational interventions in patients with type 2 diabetes during an 11-year period (2003-2013). Studies were evaluated using a quality assessment scale adapted from Jadad scale and Cochrane handbook. Extraction of data was carried out by two reviewers. A random-effect model with a standardized mean difference and Hedges's g indices was used for conducting the meta-analysis. Subgroup analyses were conducted and a Funnel plot was used to examine publication bias.
Ten studies overall were identified that fulfilled inclusion criteria, involving a total of 960 participants. The mean age of the sample was 52.8 years and majority were females. Data were heterogeneous (I(2)=67.6). Analyses suggested a publication bias based on Egger's regression (P<0.05). HbA1c was reduced significantly in experimental groups compared to control groups (P<0.001). The effect size for glycemic control in studies that used text-messaging only was 44%. For studies that used both text-messaging and Internet, the effect size was 86%.
Mobile text-messaging for educating Type 2 diabetics appears to be effective on glycemic control. Further investigations on mobile applications to achieve educational goals involving other diseases are recommended.
2型糖尿病在全球范围内日益严重，可通过教育进行管理。使用手机发送短信有助于自我护理。本研究旨在系统评价通过移动短信进行教育对血糖控制的影响。
采用系统评价和荟萃分析的设计。检索了五个电子数据库，以获取在11年期间（2003 - 2013年）对2型糖尿病患者使用短信教育干预的随机对照试验设计的英文研究。使用从Jadad量表和Cochrane手册改编的质量评估量表对研究进行评估。由两名审阅者进行数据提取。使用具有标准化均数差和Hedges's g指数的随机效应模型进行荟萃分析。进行亚组分析，并使用漏斗图检查发表偏倚。
共确定了10项符合纳入标准的研究，涉及960名参与者。样本的平均年龄为52.8岁，大多数为女性。数据具有异质性（I(2)=67.6）。基于Egger回归分析提示存在发表偏倚（P<0.05）。与对照组相比，实验组的糖化血红蛋白（HbA1c）显著降低（P<0.001）。仅使用短信的研究中血糖控制的效应量为44%。对于同时使用短信和互联网的研究，效应量为86%。
通过移动短信对2型糖尿病患者进行教育似乎对血糖控制有效。建议进一步研究移动应用程序在实现涉及其他疾病的教育目标方面的作用。
