Tsokani Sofia, Seitidis Georgios, Christogiannis Christos, Kontouli Katerina-Maria, Nikolakopoulos Stavros, Zevgiti Stella, Orrego Carola, Ballester Marta, Suñol Rosa, Heijmans Monique, Poortvliet Rune, van der Gaag Marieke, Alonso-Coello Pablo, Canelo-Aybar Carlos, Beltran Jessica, González-González Ana I, de Graaf Gimon, Veroniki Areti-Angeliki, Mavridis Dimitrios
Department of Primary Education, University of Ioannina, 451 10 Ioannina, Greece.
Methods Support Unit, Cochrane CET, London SW1Y 4QX, UK.
Healthcare (Basel). 2023 Dec 22;12(1):27. doi: 10.3390/healthcare12010027.
Chronic diseases are a leading cause of global morbidity and mortality. In response to this challenge, self-management interventions (SMIs) have emerged as an essential tool in improving patient outcomes. However, the diverse and complex nature of SMIs pose significant challenges in measuring their effectiveness. This work aims to investigate the comparative effectiveness of SMIs on Type 2 diabetes mellitus (T2DM) outcomes.
A rigorous analytical framework was employed to assess the relative effectiveness of different SMIs, encompassing both pairwise and network meta-analysis (NMA), as well as component network meta-analysis (CNMA). Various outcomes were considered, including glycated hemoglobin (HbA1c) control, body mass index (BMI) reduction and low-density lipoprotein (LDL) cholesterol. Visualization tools were also utilized to enhance the interpretation of results.
SMIs were found promising in improving clinical outcomes and patient-reported measures. However, considerable heterogeneity and inconsistency across studies challenged the validity of NMA results. CNMA along with various visualization tools offered insights into the contributions of individual SMI components, highlighting the complexity of these interventions.
DISCUSSION/CONCLUSIONS: SMIs represent a valuable approach to managing chronic conditions, but their effectiveness is context-dependent. Further research is needed to elucidate the contextual factors influencing SMI outcomes. This work contributes to a comprehensive understanding of SMIs' role in T2DM management, aiming to aid decision-makers, clinicians, and patients in selecting tailored interventions.
慢性病是全球发病和死亡的主要原因。为应对这一挑战，自我管理干预措施已成为改善患者预后的重要工具。然而，自我管理干预措施的多样性和复杂性给衡量其有效性带来了重大挑战。这项工作旨在研究自我管理干预措施对2型糖尿病（T2DM）预后的比较有效性。
采用严格的分析框架来评估不同自我管理干预措施的相对有效性，包括成对和网络荟萃分析（NMA）以及成分网络荟萃分析（CNMA）。考虑了各种结果，包括糖化血红蛋白（HbA1c）控制、体重指数（BMI）降低和低密度脂蛋白（LDL）胆固醇。还使用了可视化工具来加强对结果的解释。
发现自我管理干预措施在改善临床结果和患者报告的指标方面很有前景。然而，各研究之间存在相当大的异质性和不一致性，这对网络荟萃分析结果的有效性提出了挑战。成分网络荟萃分析以及各种可视化工具提供了对各个自我管理干预措施组成部分贡献的见解，突出了这些干预措施的复杂性。
讨论/结论：自我管理干预措施是管理慢性病的一种有价值的方法，但其有效性取决于具体情况。需要进一步研究以阐明影响自我管理干预措施结果的背景因素。这项工作有助于全面理解自我管理干预措施在2型糖尿病管理中的作用，旨在帮助决策者、临床医生和患者选择量身定制的干预措施。
