School of Health and Society, University of Wollongong, Wollongong, NSW 2525, Australia.
Int J Environ Res Public Health. 2021 Nov 19;18(22):12171. doi: 10.3390/ijerph182212171.
Primary health care physicians are increasingly offering telehealth services to patients not only for its cost and time saving advantages but for the additional benefits telehealth can provide for patients with type 2 diabetes (T2D) such as improved self-management behaviours. To support the development of telehealth based T2D clinical care models in primary health care settings, a narrative synthesis and meta-analysis of randomised controlled trial studies was completed for 29 studies that evaluated the effect of one or more types of telehealth interventions on HbA1c levels compared to usual care alone. Results from the random effects meta-analysis demonstrated that telehealth interventions had a stronger influence on HbA1c compared to usual care with a mean difference in HbA1c % -0.18 (CI -0.35, -0.01), = 0.04. Results from the subgroup meta-analysis demonstrated that telehealth interventions, when grouped by type of telemonitoring (mHealth and telephone communication), all have a stronger effect on lowering HbA1c levels; however, none of these findings were significant. Key findings from this review demonstrate that telehealth interventions that address T2D self-management behaviours and have higher levels of health care provider engagement, have greater effects on lowering HbA1c levels compared to usual care alone.
基层医疗保健医生越来越多地为患者提供远程医疗服务，不仅因为其具有成本和节省时间的优势，还因为远程医疗可以为 2 型糖尿病（T2D）患者提供额外的益处，例如改善自我管理行为。为了支持在基层医疗保健环境中开发基于远程医疗的 T2D 临床护理模式，对 29 项评估一种或多种远程医疗干预措施对糖化血红蛋白（HbA1c）水平的影响的随机对照试验研究进行了叙述性综合和荟萃分析，与单独常规护理相比。来自随机效应荟萃分析的结果表明，与常规护理相比，远程医疗干预对 HbA1c 的影响更强，HbA1c 的平均差异为-0.18%（CI-0.35，-0.01）， = 0.04。亚组荟萃分析的结果表明，按远程监测类型（移动医疗和电话沟通）分组的远程医疗干预措施均对降低 HbA1c 水平具有更强的作用；然而，这些发现均不显著。本综述的主要发现表明，与单独常规护理相比，针对 T2D 自我管理行为且医疗保健提供者参与度更高的远程医疗干预措施对降低 HbA1c 水平的效果更大。
