Dobson Rosie, Whittaker Robyn, Pfaeffli Dale Leila, Maddison Ralph
National Institute for Health Innovation, University of Auckland, New Zealand.
Institute for Innovation and Improvement, Waitemata District Health Board, New Zealand.
Digit Health. 2017 Nov 9;3:2055207617740315. doi: 10.1177/2055207617740315. eCollection 2017 Jan-Dec.
BACKGROUND: Poorly controlled diabetes leads to debilitating complications at a significant cost to health systems. Text messaging is an ideal platform for the delivery of self-management interventions to patients with poorly controlled diabetes due to the ubiquity of mobile phones, and the ability of text messaging to reach people in their everyday lives when self-management of the condition is vital. This systematic review aimed to assess the effectiveness of short message service-based diabetes self-management interventions on glycaemic control in adults with poorly controlled diabetes. METHODS/DESIGN: MEDLINE, PubMed, EMBASE, The Cochrane Library and PsychINFO were searched from inception through to 23 January 2017 for randomised controlled trials investigating the use of text messaging based self-management interventions on haemoglobin A1c for patients with poorly controlled diabetes. RESULTS: Seven studies met the inclusion criteria and were included in the review. Three of the studies reported a significant decrease in haemoglobin A1c from baseline to follow-up in the intervention group compared to the control group. No clear relationship between positive outcomes and intervention dose, content and functionality was seen. DISCUSSION: Evidence supporting text messaging for improvements in glycaemic control in people with poorly controlled diabetes is mixed. Previous reviews have reported positive impacts on glycaemic control for short message service interventions in patients with diabetes; however, when limited to those with poorly controlled diabetes the evidence is less clear. Large-scale studies with robust methodology and longer-term follow-up are needed to further understand the impact of text-messaging-based self-management interventions for people with poorly controlled diabetes.
背景:糖尿病控制不佳会导致使人衰弱的并发症,给卫生系统带来巨大成本。由于手机的普及,以及短信能够在糖尿病自我管理至关重要的日常生活中触达人们,短信是向糖尿病控制不佳的患者提供自我管理干预措施的理想平台。本系统评价旨在评估基于短信服务的糖尿病自我管理干预措施对糖尿病控制不佳的成年人血糖控制的有效性。 方法/设计:检索了MEDLINE、PubMed、EMBASE、Cochrane图书馆和PsychINFO,检索时间从建库至2017年1月23日,以查找随机对照试验,这些试验研究了基于短信的自我管理干预措施对糖尿病控制不佳患者糖化血红蛋白的影响。 结果:七项研究符合纳入标准并被纳入本评价。其中三项研究报告称,与对照组相比,干预组从基线到随访时糖化血红蛋白显著降低。未发现积极结果与干预剂量、内容和功能之间存在明确关系。 讨论:支持通过短信改善糖尿病控制不佳患者血糖控制的证据不一。以往的综述报告了短信服务干预措施对糖尿病患者血糖控制有积极影响;然而,仅限于糖尿病控制不佳的患者时,证据不太明确。需要开展具有稳健方法和长期随访的大规模研究,以进一步了解基于短信的自我管理干预措施对糖尿病控制不佳患者的影响。
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