远程医疗在印度管理2型糖尿病的临床效果：远程医疗与门诊就诊影响的荟萃分析
The clinical effectiveness of telemedicine for managing type 2 diabetes in India: a meta-analysis of the impact of telemedicine with clinic visits.
作者信息
Nath Anita, Mathew Stany, Pant Apourv, Thadi Yamini
机构信息
Indian Council of Medical Research-National Centre for Disease Informatics and Research, ICMR Complex-Nirmal Bhavan, 562110 Bengaluru, Karnataka India.
出版信息
J Diabetes Metab Disord. 2024 Jul 27;23(2):2095-2104. doi: 10.1007/s40200-024-01471-x. eCollection 2024 Dec.
OBJECTIVES
Telemedicine has emerged as a promising solution for enhancing Type 2 diabetes management, which aims to reduce healthcare costs and improve patient outcomes. Despite its potential benefits for diabetes management in India, knowledge of its clinical effectiveness is scarce. This meta-analysis examines the clinical effectiveness of telemedicine versus physical consultation in managing Type 2 diabetes in India.
METHODS
The meta-analysis adhered to the PRISMA-P guidelines and was registered with PROSPERO (CRD42023400562). PubMed and EMBASE were searched for eligible studies from 1st January 2012 to 30th June 2022. Included were studies on Type 2 diabetes patients in India comparing telemedicine (Intervention) with physical consultation (conventional) regarding effect on HbA1c changes. Risk of bias for randomised studies of Intervention (RoB-2) was used for study quality assessment.
RESULTS
We found four articles that met the eligibility criteria, all reporting quantitative HbA1c change. The telemedicine interventions included video consultation, health systemcomputer-generated telephonic messages and a Video-Based Lifestyle Education Programme. Upon pooling the results from these studies, an overall analysis indicated a non-statistically significant reduction in HbA1c levels following the intervention compared to conventional treatment (pooled difference in means = -0.03, 95% CI = -0.23 to 0.17, Z = 0.30 = 0.76). Likewise, there was no statistically significant difference in secondary outcomes (Body Mass Index, body weight and lipid profile) between both treatment groups.
CONCLUSION
Enhancing telemedicine approaches may hold promise in improving type 2 diabetes management in India, although the existing evidence remains inconclusive. Further research involving long-term telemedicine interventions would help to provide more substantial evidence on the clinical effectiveness of telemedicine for Type 2 diabetes management in India.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-024-01471-x.
目的
远程医疗已成为改善2型糖尿病管理的一种有前景的解决方案，其旨在降低医疗成本并改善患者预后。尽管其对印度糖尿病管理有潜在益处，但其临床有效性的相关知识却很匮乏。本荟萃分析考察了远程医疗与面对面咨询在印度管理2型糖尿病方面的临床有效性。
方法
本荟萃分析遵循PRISMA-P指南，并在PROSPERO（CRD42023400562）注册。检索了PubMed和EMBASE中2012年1月1日至2022年6月30日的符合条件的研究。纳入的是关于印度2型糖尿病患者的研究，比较了远程医疗（干预）与面对面咨询（传统方式）对糖化血红蛋白（HbA1c）变化的影响。采用干预随机研究的偏倚风险（RoB-2）进行研究质量评估。
结果
我们发现4篇符合纳入标准的文章，均报告了HbA1c的定量变化。远程医疗干预包括视频咨询、卫生系统计算机生成的电话信息以及基于视频的生活方式教育项目。汇总这些研究结果后，总体分析表明，与传统治疗相比，干预后HbA1c水平的降低无统计学意义（合并均值差异=-0.03，95%置信区间=-0.23至0.17，Z=0.30，P=0.76）。同样，两个治疗组在次要结局（体重指数、体重和血脂谱）方面也无统计学显著差异。
结论
尽管现有证据尚无定论，但加强远程医疗方法可能有望改善印度的2型糖尿病管理。涉及长期远程医疗干预的进一步研究将有助于为远程医疗在印度2型糖尿病管理中的临床有效性提供更充分的证据。
补充信息
在线版本包含可在10.1007/s40200-024-01471-x获取的补充材料。
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