远程监测对 2 型糖尿病患者糖化血红蛋白水平的维持效果：系统评价。

The Efficacy of Tele-Monitoring in Maintaining Glycated Haemoglobin Levels in Patients with Type 2 Diabetes Mellitus: A Systematic Review.

机构信息

Woodlands Health Centre, 4, Edwin Hall Place, Hither Green Lane, London SE13 6RN, UK.

School of Health Sciences, Avery Hill Campus, University of Greenwich, Avery Hill Road, London SE9 2UG, UK.

出版信息

Int J Environ Res Public Health. 2022 Dec 13;19(24):16722. doi: 10.3390/ijerph192416722.

DOI:10.3390/ijerph192416722

PMID:36554601

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9779018/

Abstract

BACKGROUND

It is well documented that telemedicine offers effective accessibility and consistency which are useful in overcoming the barriers associated with the traditional delivery of chronic disease management. Furthermore, home-based telemonitoring approach for managing chronic disease conditions has been shown to break geographical barriers and facilitate provider-to-patient communication. However, the efficacy of telemedicine in reducing HbA1c is debatable.

AIM

This systematic review aims to evaluate the effect of telemedicine on glycaemic control in patients with type 2 diabetes.

METHOD

This systematic review has been conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Searches were primarily conducted using the EBSCOhost database. Other search engines such as Cochrane Library and Google scholar were also used and search of grey literature was performed using google, NHS.uk website, WHO websites, and gov.uk website. Nine articles were included in this review.

RESULTS

Three themes were identified in this review including diabetes education/telemonitoring technology and glycaemic control, the attitude of participants, and cost effectiveness of tele-medicine. While three studies reported improved glycaemic control with statistically significant improvement in HbA1c compared to the control group, three other studies did not find significant improvement in glycaemic control. In addition, the findings suggest that participants' positive attitude to self-care can lead to an improved HbA1c, and finally, several of the selected studies found that telemonitoring is not cost-effective.

CONCLUSION

The findings of this review show that telemedicine may be effective in managing blood glucose in patients with type 2 diabetes. However, factors such as educational level of patients, attitude and costs may limit its application in primary care. More studies are required to fully establish the effectiveness of Telemonitoring in managing patients with type 2 diabetes.

摘要

背景

有大量文献证明，远程医疗在克服慢性病管理传统模式相关障碍方面具有有效性和一致性，这一点非常有用。此外，通过家庭远程监测来管理慢性病的方法已被证明可以打破地域障碍，促进医患沟通。然而，远程医疗在降低糖化血红蛋白方面的疗效仍存在争议。

目的

本系统评价旨在评估远程医疗在 2 型糖尿病患者血糖控制方面的效果。

方法

本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）框架进行。主要使用 EBSCOhost 数据库进行搜索。还使用了 Cochrane Library 和 Google Scholar 等其他搜索引擎，并通过谷歌、NHS.uk 网站、世界卫生组织网站和 gov.uk 网站对灰色文献进行了搜索。本综述共纳入 9 篇文章。

结果

本综述确定了 3 个主题，包括糖尿病教育/远程监测技术和血糖控制、参与者的态度以及远程医疗的成本效益。虽然有 3 项研究报告称，与对照组相比，糖化血红蛋白有统计学意义的改善，从而改善了血糖控制，但另外 3 项研究没有发现血糖控制有显著改善。此外，研究结果表明，参与者对自我护理的积极态度可以改善糖化血红蛋白，最后，一些选定的研究发现远程监测并不具有成本效益。