Unit of Therapeutic Patient Education, WHO Collaborating Centre, Division of Endocrinology, Diabetology, Nutrition and Therapeutic Patient Education, Geneva University Hospitals and University of Geneva, 1206 Geneva, Switzerland.
Institute of Population Health, University of Liverpool, Liverpool L69 7ZA, UK.
Nutrients. 2022 Sep 15;14(18):3807. doi: 10.3390/nu14183807.
Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis present a critical synthesis of the development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus qualitatively synthesized. Out of these, 47 were included in the quantitative synthesis. There was substantial heterogeneity in the reporting of these outcomes (I2 = 88.35%, Q = 317.64), with a significant improvement noted in serum HbA1c levels (standardized mean difference (SMD) = 0.272, 95% CI: 0.118 to 0.525, n = 7360) and body weight (SMD = 0.526, 95% CI: 0.205 to 0.846, n = 1082) in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (p < 0.001). These interventions should be implemented in healthcare and community settings to improve the health outcomes in patients suffering from obesity and DM.
糖尿病（DM）和肥胖症是导致非传染性疾病负担最重的疾病。越来越多的证据表明，治疗性患者教育（TPE）是一种具有临床和成本效益的解决方案，可以改善 DM 和肥胖患者的生物医学和社会心理结局。本系统评价和荟萃分析对 TPE 干预 DM 和肥胖症的发展以及这些干预措施在一系列生物医学、社会心理和心理结局方面的疗效进行了批判性综合。在肥胖和糖尿病患者中总共确定了 54 项这些 RCT，并对其进行了定性综合。其中，47 项被纳入定量综合。这些结果的报告存在很大的异质性（I2 = 88.35%，Q = 317.64），在血清 HbA1c 水平（标准化均数差（SMD）= 0.272，95%CI：0.118 至 0.525，n = 7360）和体重（SMD = 0.526，95%CI：0.205 至 0.846，n = 1082）方面观察到显著改善。不同模式和传递剂实施的干预措施的效果大小相当。这些干预措施可以由联合健康工作人员、医生或电子方式（如自助程序）提供，具有相似的有效性（p < 0.001）。这些干预措施应在医疗保健和社区环境中实施，以改善肥胖和 DM 患者的健康结局。
