We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Self-Management Interventions for Adults Living with Type II Diabetes to Improve Patient-Important Outcomes: An Evidence Map.
- Authors
Song, Yang; Beltran Puerta, Jessica; Medina-Aedo, Melixa; Canelo-Aybar, Carlos; Valli, Claudia; Ballester, Marta; Rocha, Claudio; Garcia, Montserrat León; Salas-Gama, Karla; Kaloteraki, Chrysoula; Santero, Marilina; Niño de Guzmán, Ena; Spoiala, Cristina; Gurung, Pema; Willemen, Fabienne; Cools, Iza; Bleeker, Julia; Poortvliet, Rune; Laure, Tajda; Gaag, Marieke van der
- Abstract
Self-management interventions (SMIs) may be promising in the treatment of Diabetes Mellitus Type 2 (T2DM). However, accurate comparisons of their relative effectiveness are challenging, partly due to a lack of clarity and detail regarding the intervention content being evaluated. This study summarizes intervention components and characteristics in randomized controlled trials (RCTs) related to T2DM using a taxonomy for SMIs as a framework and identifies components that are insufficiently incorporated into the design of the intervention or insufficiently reported. Following evidence mapping methodology, we searched MEDLINE, CINAHL, Embase, Cochrane, and PsycINFO from 2010 to 2018 for randomized controlled trials (RCTs) on SMIs for T2DM. We used the terms 'self-management', 'adult' and 'T2DM' for content. For data extraction, we used an online platform based on the taxonomy for SMIs. Two independent reviewers assessed eligible references; one reviewer extracted data, and a second checked accuracy. We identified 665 RCTs for SMIs (34% US, 21% Europe) including 164,437 (median 123, range 10–14,559) adults with T2DM. SMIs highly differed in design and content, and characteristics such as mode of delivery, intensity, location and providers involved were poorly described. The majority of interventions aimed to improve clinical outcomes like HbA1c (83%), weight (53%), lipid profile (45%) or blood pressure (42%); 27% (also) targeted quality of life. Improved knowledge, health literacy, patient activation or satisfaction with care were hardly used as outcomes (<16%). SMIs most often used education (98%), self-monitoring (56%), goal-setting (48%) and skills training (42%) to improve outcomes. Management of emotions (17%) and shared decision-making (5%) were almost never mentioned. Although diabetes is highly prevalent in some minority groups, in only 13% of the SMIs, these groups were included. Our findings highlight the large heterogeneity that exists in the design of SMIs for T2DM and the way studies are reported, making accurate comparisons of their relative effectiveness challenging. In addition, SMIs pay limited attention to outcomes other than clinical, despite the importance attached to these outcomes by patients. More standardized and streamlined research is needed to better understand the effectiveness and cost-effectiveness of SMIs of T2DM and benefit patient care.
- Subjects
EVALUATION of medical care; CINAHL database; MEDICAL databases; PSYCHOLOGY information storage &; retrieval systems; MEDICAL information storage &; retrieval systems; PROBLEM solving; SOCIAL support; SELF-management (Psychology); SYSTEMATIC reviews; PATIENT satisfaction; ACQUISITION of data; TYPE 2 diabetes; HEALTH literacy; QUALITY assurance; DECISION making; MEDICAL records; RESEARCH funding; MEDLINE; GOAL (Psychology)
- Publication
Healthcare (2227-9032), 2023, Vol 11, Issue 24, p3156
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare11243156