Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, The Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
BMJ Open. 2022 May 25;12(5):e054650. doi: 10.1136/bmjopen-2021-054650.
This study examined the effect of using patient-reported outcome measures (PROMs) routinely to assess and address depressive symptoms and diabetes distress among adults with type 2 diabetes.
A systematic review of published peer-reviewed studies.
Medline, Embase, CINAHL Complete, PsycINFO, The Cochrane Library and Cochrane Central Register of Controlled Trials were searched.
Studies including adults with type 2 diabetes, published in English, from the inception of the databases to 24 February 2022 inclusive; and where the intervention included completion of a PROM of depressive symptoms and/or diabetes distress, with feedback of the responses to a healthcare professional.
Using Covidence software, screening and risk of bias assessment were conducted by two reviewers independently with any disagreements resolved by a third reviewer.
The search identified 4512 citations, of which 163 full-text citations were assessed for eligibility, and nine studies met the inclusion criteria. Five studies involved assessment of depressive symptoms only, two studies assessed diabetes distress only, and two studies assessed both. All studies had an associated cointervention. When depressive symptoms were assessed (n=7), a statistically significant between-group difference in depressive symptoms was observed in five studies; with a clinically significant (0.5%) between-group difference in HbA1c in two studies. When diabetes distress was assessed (n=4), one study demonstrated statistically significant difference in depressive symptoms and diabetes distress; with a clinically significant between-group difference in HbA1c observed in two studies.
Studies are sparse in which PROMs are used to assess and address depressive symptoms or diabetes distress during routine clinical care of adults with type 2 diabetes. Further research is warranted to understand how to integrate PROMs into clinical care efficiently and determine appropriate interventions to manage identified problem areas.
CRD42020200246.
本研究旨在考察在常规评估和处理 2 型糖尿病成人患者抑郁症状和糖尿病困扰时使用患者报告结局测量（PROM）的效果。
对已发表的同行评议研究进行系统回顾。
在 Medline、Embase、CINAHL Complete、PsycINFO、The Cochrane Library 和 Cochrane 对照试验中心注册库中进行了检索。
纳入研究的对象为患有 2 型糖尿病的成年人，研究发表于英文文献，且检索范围涵盖数据库建立至 2022 年 2 月 24 日的所有文献；干预措施包括完成抑郁症状和/或糖尿病困扰的 PROM，并将反馈结果提供给医疗保健专业人员。
使用 Covidence 软件，两名评审员独立进行筛选和风险评估，任何分歧均由第三名评审员解决。
检索共确定 4512 篇引文，其中 163 篇全文引文进行了资格评估，9 项研究符合纳入标准。5 项研究仅评估了抑郁症状，2 项研究仅评估了糖尿病困扰，2 项研究同时评估了两者。所有研究均存在伴随的联合干预措施。在评估抑郁症状时（n=7），5 项研究观察到抑郁症状的组间差异具有统计学意义；其中 2 项研究观察到 HbA1c 的组间差异具有临床意义（0.5%）。在评估糖尿病困扰时（n=4），1 项研究显示抑郁症状和糖尿病困扰存在统计学差异；其中 2 项研究观察到 HbA1c 的组间差异具有临床意义。
在 2 型糖尿病成人患者的常规临床护理中使用 PROM 评估和处理抑郁症状或糖尿病困扰的研究较少。需要进一步研究以了解如何高效地将 PROM 整合到临床护理中，并确定管理已识别问题领域的适当干预措施。
PROSPERO 注册号：CRD42020200246。
