Lo Monaco Marika, Profeta Arianna, Corrao Salvatore
Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties [PROMISE], University of Palermo, Palermo, Italy.
University Hospital "Paolo Giaccone", Palermo, Italy.
Nurs Open. 2025 Jul;12(7):e70265. doi: 10.1002/nop2.70265.
To evaluate telenursing interventions' effectiveness in managing patients with diabetes mellitus.
Overview of systematic reviews.
According to the PRISMA statement, we included studies published from 2005 to 2023 that evaluated telenursing interventions for adult diabetic patients and reported physiological, behavioural, and clinical outcomes. AMSTAR 2 was used to assess the quality of the included studies.
We conducted an umbrella review from July 2023 to May 2024, searching Cochrane Library, PubMed, SCOPUS, and PROSPERO for systematic reviews published from inception to May 10, 2024.
Thirty-one eligible systematic reviews were identified. Most (n = 23) reported positive effects of telenursing interventions (telephone calls, text messaging, mobile software applications, telecoaching) on reducing glycated haemoglobin (HbA1c). Findings on weight loss, hypoglycaemia, and quality of life were heterogeneous. Telenursing interventions promoted self-management behaviours like medication adherence and dietary improvements. While several studies suggested potential cost-effectiveness, further studies are needed to explore the long-term economic impact of telenursing on diabetes management.
Telenursing appears to be a promising approach for improving diabetes management, particularly in self-management behaviours and HbA1c control. Further research is needed to explore the long-term sustainability, cost-effectiveness, and optimal telenursing protocols for diabetes care.
IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: This umbrella review highlights the significant role of telenursing in improving diabetes management and patient outcomes. Nurse-led telehealth interventions have demonstrated their ability to enhance patient self-management, adherence to treatment plans, and overall well-being. Additionally, by reducing hospitalisations and healthcare costs and increasing access to care for patients living in rural areas, nurse-led telehealth interventions represent an effective strategy for improving diabetes care despite initial costs. Given these findings, healthcare providers and policymakers should implement telenursing programs to enhance patient care and system efficiency.
The authors adhered to the EQUATOR guidelines using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and "the Preferred Reporting Items for Overviews of Reviews Statement" (PRIOR) for the reporting.
There was no patient contribution. The European Union-ERDF or ESF, OP Research and Innovation 2014-2020-DM 1062/2021 co-financed the publication.
International Prospective Register of Systematic Reviews (PROSPERO) with the protocol number CRD42023427103 https://www.crd.york.ac.uk/PROSPEROFILES/427103_STRATEGY_20230719.pdf.
评估远程护理干预对糖尿病患者管理的有效性。
系统评价概述。
根据PRISMA声明，我们纳入了2005年至2023年发表的研究，这些研究评估了针对成年糖尿病患者的远程护理干预，并报告了生理、行为和临床结果。使用AMSTAR 2评估纳入研究的质量。
我们在2023年7月至2024年5月进行了一项综合评价，在Cochrane图书馆、PubMed、SCOPUS和PROSPERO中检索从创刊到2024年5月10日发表的系统评价。
确定了31项符合条件的系统评价。大多数（n = 23）报告了远程护理干预（电话、短信、移动软件应用程序、远程指导）对降低糖化血红蛋白（HbA1c）的积极作用。关于体重减轻、低血糖和生活质量的研究结果存在异质性。远程护理干预促进了自我管理行为，如药物依从性和饮食改善。虽然几项研究表明可能具有成本效益，但需要进一步研究来探讨远程护理对糖尿病管理的长期经济影响。
远程护理似乎是改善糖尿病管理的一种有前景的方法，特别是在自我管理行为和HbA1c控制方面。需要进一步研究来探索糖尿病护理的长期可持续性、成本效益和最佳远程护理方案。
对专业和/或患者护理的意义：本综合评价强调了远程护理在改善糖尿病管理和患者结局方面的重要作用。由护士主导的远程医疗干预已证明其能够增强患者的自我管理、对治疗计划的依从性以及整体幸福感。此外，通过减少住院次数和医疗费用，并增加农村地区患者获得护理的机会，由护士主导的远程医疗干预代表了一种尽管初始成本较高但改善糖尿病护理的有效策略。鉴于这些发现，医疗保健提供者和政策制定者应实施远程护理计划，以提高患者护理水平和系统效率。
作者遵循EQUATOR指南，使用系统评价和Meta分析的首选报告项目（PRISMA）以及“综述概述的首选报告项目声明”（PRIOR）进行报告。
没有患者参与。欧盟-欧洲区域发展基金或欧洲社会基金、2014 - 2020年研究与创新行动计划 - DM 1062/2021共同资助了本出版物。
国际前瞻性系统评价注册库（PROSPERO），方案编号CRD42023427103 https://www.crd.york.ac.uk/PROSPEROFILES/427103_STRATEGY_20230719.pdf 。
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