远程护理在糖尿病管理中的作用：系统评价和荟萃分析。

The role of telenursing in the management of diabetes：A systematic review and meta-analysis.

机构信息

Department of Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.

Anhui Medical College, Hefei, China.

出版信息

Public Health Nurs. 2019 Jul;36(4):575-586. doi: 10.1111/phn.12603. Epub 2019 Mar 18.

DOI:10.1111/phn.12603

PMID:30883888

Abstract

BACKGROUND

Diabetes is a common chronic disease that requires a long-term regimen. However, the management of diabetes by telenursing is limited and inconclusive.

OBJECTIVES

To determine the effectiveness of telenursing on control in diabetes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS

We searched electronic databases, including PubMed, Embase, Web of Science and Cochrane Library. Studies comparing telenursing with usual care in diabetes patients were included.

RESULTS

A total of 17 randomized controlled trials were identified. Glycated hemoglobin (HbA1c) dates were pooled using a random effects meta-analysis method, followed by subgroup analyses to examine heterogeneity. The meta-analysis showed that the use of telenursing (vs. usual care) was associated with a significant reduction in HbA1c levels compared to usual care, with a pooled 0.68% (95% CI: 0.33-1.03, p = 0.0001; I = 95%). For the secondary outcome, the SMD of body mass index (BMI) was -0.25% (95% CI: -0.81 to 0.32%, p = 0.39), with no statistically significant change; the fasting blood sugar (FBS) SMD was -0.19% (95% CI: 0.20 to 1.01, p = 0.003), with a statistically significant change; the total cholesterol (TC) SMD was -0.09% (95% CI: -0.03 to 0.21, p = 0.12), with no statistically significant change.

CONCLUSIONS

Telenursing, as a useful tool for patient education and behavioral interventions, can help diabetes patients to improve their glycemic control. However, more studies on up-to-date and cost-effective technologies are needed.

摘要

背景

糖尿病是一种常见的慢性病，需要长期治疗。然而，远程护理在糖尿病管理中的应用效果有限，结论尚不明确。

目的

评估远程护理在糖尿病患者血糖控制中的应用效果。我们进行了系统评价和荟萃分析。

方法

我们检索了电子数据库，包括 PubMed、Embase、Web of Science 和 Cochrane Library，纳入了比较远程护理与常规护理对糖尿病患者影响的随机对照试验。

结果

共纳入 17 项随机对照试验。采用随机效应荟萃分析方法对糖化血红蛋白（HbA1c）数据进行汇总，然后进行亚组分析以检验异质性。荟萃分析结果显示，与常规护理相比，远程护理可显著降低 HbA1c 水平，差异有统计学意义（加权均数差为-0.68%，95%可信区间：-0.33%至-1.03%，p=0.0001；I²=95%）。次要结局方面，体质指数（BMI）的标准化均数差（SMD）为-0.25%（95%可信区间：-0.81%至 0.32%，p=0.39），差异无统计学意义；空腹血糖（FBS）的 SMD 为-0.19%（95%可信区间：0.20%至 1.01%，p=0.003），差异有统计学意义；总胆固醇（TC）的 SMD 为-0.09%（95%可信区间：-0.03%至 0.21%，p=0.12），差异无统计学意义。