1 Post-doctoral Fellow and Adjunct Assistant Professor, The Education University of Hong Kong.
2 Peter T C Lee Chair Professor of Health Studies, The Education University of Hong Kong.
J Telemed Telecare. 2018 Jun;24(5):356-364. doi: 10.1177/1357633X17700552. Epub 2017 May 2.
Background Diabetes mellitus is prevalent worldwide and the majority of the patients with this metabolic disease are managed in primary healthcare settings. Self-management is, therefore, crucial for the health and wellbeing of people with diabetes. Due to the advancement of information technologies, telehealth intervention as self-management measures potentially offer a possible solution in the primary healthcare arena to cope with the increasing demand for diabetes control. Methods This study aims to systematically review the effectiveness of telehealth on diabetes control self-management in primary healthcare settings. A keyword search was conducted in six databases for randomised controlled trials. Data extraction and quality assessment of the reviewed studies were done with standardised forms and checklists. A meta-analysis was also performed in this review. Results Of the seven studies included in this review, all of them reported a decreasing level of glycated haemoglobin. Four studies examined the effect of telehealth interventions on fasting plasma glucose levels; however, the overall effects were insignificant. It is, nonetheless, encouraging to see two studies which investigated their effect on two-hour post-meal glucose levels, and showed positive effects for glycaemic control self-management in the short term. This finding, though only from two studies, points to a promising future of utilising telehealth interventions in controlling this metabolic disease in the primary healthcare arena. Conclusions This review showed positive effects of telehealth interventions for diabetes control self-management at the primary healthcare stage. Further studies are required to evaluate the cost-effectiveness of telehealth interventions.
糖尿病在全球范围内普遍存在，大多数患有这种代谢性疾病的患者在初级保健环境中接受管理。因此，自我管理对糖尿病患者的健康和福祉至关重要。由于信息技术的进步，远程医疗干预作为自我管理措施，有可能为满足日益增长的糖尿病控制需求提供初级保健领域的一种解决方案。
本研究旨在系统地回顾远程医疗在初级保健环境中对糖尿病控制自我管理的有效性。在六个数据库中进行了关键词搜索，以寻找随机对照试验。使用标准化表格和清单对综述研究进行数据提取和质量评估。本综述还进行了荟萃分析。
在纳入的七项研究中，所有研究都报告糖化血红蛋白水平降低。四项研究检查了远程医疗干预对空腹血糖水平的影响；然而，总体效果并不显著。不过，有两项研究调查了它们对餐后两小时血糖水平的影响，这两项研究显示出远程医疗干预在短期对血糖控制自我管理有积极影响，令人鼓舞。这一发现虽然仅来自两项研究，但指向了在初级保健领域利用远程医疗干预控制这种代谢性疾病的未来充满希望。
本综述表明远程医疗干预对初级保健阶段的糖尿病控制自我管理有积极影响。需要进一步研究来评估远程医疗干预的成本效益。
