Sari Citra Windani Mambang, Haroen Hartiah, Juniarti Neti, Amalia Lisda, Pardosi Jerico Franciscus
Doctoral Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia.
Department of Community Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia.
J Multidiscip Healthc. 2025 Sep 2;18:5441-5459. doi: 10.2147/JMDH.S536258. eCollection 2025.
Diabetes mellitus is a major health challenge among older adults in Asia. Challenges include limited healthcare access and poor self-care adherence. Continuity of care has emerged as a key strategy to enhance diabetes self-management in this population.
This review aimed to identify the continuity of care strategies in improving diabetes self-management among older adults in Asian countries.
This systematic review was conducted following the PRISMA guidelines and registered on PROSPERO (CRD420251017515). A comprehensive search was performed in five major databases, including CINAHL, PubMed, ScienceDirect, Scopus, and Taylor & Francis. Inclusion criteria covered full-text, english-language experimental studies in Asian countries. Studies were excluded due to lack of full-text access, non-English language, and secondary research. Data analysis was carried out using descriptive qualitative and thematic analysis.
A total of 12 included studies were analyzed in this review. Three categories of continuity of care strategies were identified such as social support and educational interventions, community-based interventions and integrated health management, and technology-based interventions and health monitoring. Most of the studies analyzed in this review indicate that continuity of care improves medication adherence, self-efficacy, physical activity, glycemic control, patient satisfaction, and quality of life among older adults with diabetes. For instance, several interventions reported reductions in HbA1c ranging from 0.28% to 0.7%, indicating meaningful clinical improvements in glycemic control among older adults.
Continuity of care is an effective strategy for enhancing diabetes self-management among older adults, with a combination of educational, technological, and community-based interventions yielding optimal outcomes. Integrating technology into diabetes monitoring can improve medication adherence, while social support programs and community health services play a vital role in enhancing patients' overall well-being. This study highlights the need for tailoring continuity of care strategies to the social and cultural contexts of Asian countries to maximize long-term effectiveness.
糖尿病是亚洲老年人面临的一项重大健康挑战。挑战包括医疗服务可及性有限和自我护理依从性差。连续性护理已成为增强该人群糖尿病自我管理的一项关键策略。
本综述旨在确定亚洲国家中改善老年人糖尿病自我管理的连续性护理策略。
本系统综述按照PRISMA指南进行，并在PROSPERO（CRD420251017515）上注册。在五个主要数据库中进行了全面检索，包括CINAHL、PubMed、ScienceDirect、Scopus和泰勒弗朗西斯数据库。纳入标准涵盖亚洲国家的全文、英文实验研究。因缺乏全文获取途径、非英语语言和二次研究而排除相关研究。使用描述性定性和主题分析进行数据分析。
本综述共分析了12项纳入研究。确定了三类连续性护理策略，如社会支持和教育干预、基于社区的干预和综合健康管理，以及基于技术的干预和健康监测。本综述分析的大多数研究表明，连续性护理可提高糖尿病老年人的用药依从性、自我效能感、身体活动、血糖控制、患者满意度和生活质量。例如，几项干预措施报告糖化血红蛋白降低了0.28%至0.7%，表明老年人血糖控制有显著的临床改善。
连续性护理是增强老年人糖尿病自我管理的有效策略，教育、技术和基于社区的干预相结合可产生最佳效果。将技术整合到糖尿病监测中可提高用药依从性，而社会支持项目和社区卫生服务在提高患者整体幸福感方面发挥着至关重要的作用。本研究强调需要根据亚洲国家的社会和文化背景调整连续性护理策略，以最大限度地提高长期效果。
