School of Nursing, Lanzhou University, China.
J Telemed Telecare. 2021 Jun;27(5):269-279. doi: 10.1177/1357633X211010019. Epub 2021 May 9.
Diabetes mellitus is an expanding global health problem. Currently, the home management of diabetes is mainly led by a multidisciplinary team based on telemedicine. However, the role nurses play in it remains inconclusive. This study aimed to investigate the effectiveness of nurse-led web-based intervention on glycated haemoglobin, blood pressure and lipid profile in patients with type 2 diabetes.
An exhaustive systematic literature search was undertaken using the following databases: PubMed, Web of Science, Embase, The Cochrane Central Register of Controlled Trials and CINAHL. Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias and using Modified Jadad Score system. We conducted a meta-analysis of randomized controlled trials that had been published from inception to July 2020, using Review Manager 5.3.
Eleven randomized controlled trials were selected that included 2063 participants. Meta-analyses results indicated significant effects on not only glycated haemoglobin (pooled mean difference (MD) = -0.40, 95% confidence interval (CI): -0.5 to -0.26, < 0.00001), but also on systolic blood pressure (pooled MD = -1.91, 95% CI: -3.73 to -0.09, = 0.04) and low density lipoprotein (pooled standardized MD = -0.29, 95% CI: -0.44 to -0.15, < 0.0001). There were no effects of nurse-led web-based intervention on fasting blood glucose, diastolic blood pressure, high density lipoprotein, body mass index and triglycerides.
Nurse-led web-based intervention is a promising way to complement routine clinical care. However, the specific intervention content and intervention media still need to carry out large-scale well-designed randomized controlled trials. Systematic review registration: PROSPERO CRD 42020204565.
糖尿病是一个不断扩大的全球健康问题。目前，糖尿病的家庭管理主要由基于远程医疗的多学科团队主导。然而，护士在其中的作用仍不确定。本研究旨在调查护士主导的基于网络的干预对 2 型糖尿病患者糖化血红蛋白、血压和血脂谱的有效性。
使用以下数据库进行全面的系统文献检索：PubMed、Web of Science、Embase、Cochrane 对照试验中心注册库和 CINAHL。两名调查员独立提取数据，并通过检查偏倚风险和使用改良 Jadad 评分系统评估研究质量。我们对截至 2020 年 7 月发表的随机对照试验进行了荟萃分析，使用 Review Manager 5.3。
选择了 11 项随机对照试验，共纳入 2063 名参与者。荟萃分析结果表明，不仅对糖化血红蛋白（汇总平均差值（MD）=-0.40，95%置信区间（CI）：-0.5 至-0.26， < 0.00001），而且对收缩压（汇总 MD=-1.91，95%CI：-3.73 至-0.09， = 0.04）和低密度脂蛋白（汇总标准化 MD=-0.29，95%CI：-0.44 至-0.15， < 0.0001）有显著影响。护士主导的基于网络的干预对空腹血糖、舒张压、高密度脂蛋白、体重指数和甘油三酯没有影响。
护士主导的基于网络的干预是补充常规临床护理的一种有前途的方法。然而，具体的干预内容和干预媒体仍需要进行大规模的精心设计的随机对照试验。系统评价注册：PROSPERO CRD 42020204565。
