Salehi Sahar, Olyaeemanesh Alireza, Mobinizadeh Mohammadreza, Nasli-Esfahani Ensieh, Riazi Hossein
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
National Institute for Health Research and Health Equity Research Center, Tehran University of Medical Science, Tehran, Iran.
J Diabetes Metab Disord. 2020 Jan 10;19(1):115-127. doi: 10.1007/s40200-019-00482-3. eCollection 2020 Jun.
The objective of this study is to conduct an assessment of Remote Patient Monitoring (RPM) systems compared to usual care for controlling glycosylated hemoglobin in type 2 diabetes.
The study was a systematic review with meta-analysis and meta-regression. A systematic search was performed via the most important electronic databases of medical resources, such as PubMed, Scopus and Cochrane library. The main outcome was HbA1C. The heterogeneity sources were examined using Chi-square (Q) and I2 tests. Meta-analyses were done using Stata version 11 software. Statistical significance was defined as < 0.05. Random effects model was used in meta-analysis, and the heterogeneity more than 50% was considered as significant.
The results of the systematic review and meta-analysis indicated that the effect size index (Difference of Pre-test/Post-test Control Design-2nd method "using pooled pretest SD" (DPPC2)) among users of RPM for type 2 diabetic patients was -0.32 with a confidence interval of 95% (from -0.45 to -0.19) as compared to the control group. The current study declared a vital role of RPM technology in reduction of hemoglobin glycogen levels. The results of the subgroup analysis showed that RPM is more effective for patients who are residents of cities, having intervention lengths less than 6 months, getting the orders from the physician and using the websites as their intervention type.
The current study indicted the efficacy of RPM in reducing HbA1c among type 2 diabetic patients, which could be a base for policymakers to decide on the introduction of this technology in Iran.
本研究的目的是评估远程患者监测（RPM）系统与常规护理相比，在控制2型糖尿病患者糖化血红蛋白方面的效果。
该研究是一项系统评价，并进行了荟萃分析和荟萃回归。通过最重要的医学资源电子数据库，如PubMed、Scopus和Cochrane图书馆进行了系统检索。主要结局指标是糖化血红蛋白（HbA1C）。使用卡方（Q）检验和I2检验检查异质性来源。使用Stata 11版软件进行荟萃分析。统计学显著性定义为P<0.05。荟萃分析采用随机效应模型，异质性超过50%被认为具有显著性。
系统评价和荟萃分析的结果表明，与对照组相比，2型糖尿病患者使用RPM的效应量指数（预测试/后测试对照设计-第二种方法“使用合并的预测试标准差”（DPPC2））为-0.32，95%置信区间为（-0.45至-0.19）。本研究表明RPM技术在降低血红蛋白糖原水平方面发挥了重要作用。亚组分析结果表明，RPM对城市居民、干预时长小于6个月、听从医生医嘱且使用网站作为干预类型的患者更有效。
本研究表明RPM在降低2型糖尿病患者糖化血红蛋白方面具有疗效，这可为政策制定者在伊朗引入该技术提供决策依据。
