Effects of type 2 diabetes behavioural telehealth interventions on glycaemic control and adherence: a systematic review

Abstract

We reviewed the effect of behavioural telehealth interventions on glycaemic control and diabetes self-management in patients with type 2 diabetes. The databases CINAHL, Medline and psychINFO were searched in August 2012. Journal articles were selected that had been published in English with a randomized controlled trial design using a usual care comparison group, and in which the primary intervention component was delivered by telehealth. Relevant outcome measures were glycaemic control and one or more of the following diabetes self-care areas: diet, physical activity, blood glucose self-monitoring (BGSM) or medication adherence. Interventions were excluded if they were primarily based on telemonitoring. The search retrieved 1027 articles, from which 49 were selected based on their title and abstract. Fourteen articles (reporting 13 studies) met the eligibility criteria for inclusion. Four studies reported significant improvements in glycaemic control. Five of eight studies on dietary adherence reported significant treatment effects, as did five of eight on physical activity, four of nine on blood glucose self-monitoring, and three of eight on medication adherence. Overall, behavioural telehealth interventions show promise in improving the diabetes self-care and glycaemic control of people with type 2 diabetes.

The E-Coach technology-assisted care transition system: a pragmatic randomized trial

“…In the outpatient setting, technology-assisted interventions have been used to enhance the efficiency of care delivery, to remind patients of appointments, to monitor disease status at home, and to increase healthpromoting behaviors [11][12][13]. Technologies, including interactive voice response systems (IVR), could efficiently conduct proactive monitoring, thereby reducing effort required by nurse coaches.…”

Living Well With Diabetes: 24-Month Outcomes From a Randomized Trial of Telephone-Delivered Weight Loss and Physical Activity Intervention to Improve Glycemic Control

“…Telephone-delivered interventions are increasingly being investigated as they have the potential for broad population reach, and for delivering the repeated contacts necessary to promote maintenance of behavior change and related clinical improvements (12)(13)(14)(15).…”

Using New Technologies to Improve the Prevention and Management of Chronic Conditions in Populations

“…The interventions evaluated involved remote monitoring and transmission of physiological data, assessment of health symptoms, facilitation of contact with a health care professional via telephone or video, disease-specific education, and reinforcement of self-management behaviors. Six reviews identified the effectiveness of telehealth interventions for chronic obstructive pulmonary disease (COPD) (85,99), chronic heart failure (65, 100, 104), and diabetes (21), as compared to usual care. One review found over three-quarters of studies (76%) reported positive effects of telemedicine interventions across a number of chronic conditions (asthma, COPD, heart failure, hypertension, and diabetes) (135).…”

“…One review found over three-quarters of studies (76%) reported positive effects of telemedicine interventions across a number of chronic conditions (asthma, COPD, heart failure, hypertension, and diabetes) (135). Six reviews reported reduced rates of mortality (65,85) and hospitalizations (28,65,85,99,100); reduced BMI and weight (21); increased smoking cessation, medication adherence, and BG self-monitoring (21); and improvements in glycemic control for individuals with type 2 diabetes and across several self-care behaviors, including physical activity and diet (21). Increased quality of life was reported in 66% (seven of nine reviews) of the reviews (28,65,85,99,100,125).…”

“…Less than 5% of all studies included appeared in more than one systematic review, indicating the breadth and diversity of studies reviewed. The major modes of program delivery were (a) mHealth, text messaging, mobile, and/or smart-phone technologies (n = 21) (5, 7, 14, 19, 23, 35-37, 39, 41, 44, 52, 62, 80, 90, 94, 98, 104, 110, 114, 119); (b) Web-or Internet-based programs (n = 23) (3,8,15,42,49,60,70,72,78,81,82,84,89,96,105,106,108,111,118,124,129,131,135); (c) telehealth and/or telemonitoring (n = 9) (1,21,28,56,65,85,99,100,125); and (d ) social media (n = 3) (22,87,123). One review included studies of mobile and Internet-based technologies to promote physical activity for individuals with type 2 diabetes (31).…”