Impact of self‐care programmes in type 2 diabetes mellitus population in primary health care: Systematic review and meta‐analysis

Abstract

Aims and Objectives: To evaluate the effectiveness of self-care programmes in type 2 diabetes mellitus (T2DM) population in primary health care. Background: The impact of educational interventions on T2DM has been evaluated in various contexts, but there is uncertainty about their impact in that of primary care. Design: Systematic review and meta-analysis. Methods: A search was conducted in PubMed, CINAHL, WOS and Cochrane databases for randomised controlled trials carried out in the period January 2005-December 2017, including studies with at least one face-to-face educational interventions. The quality of the evidence for the primary outcome was evaluated using the GRADE System. A meta-analysis was used to determine the effect achieved although only the results classified as critical or important were taken into consideration. Checklist of Preferred Reporting Items for Systematic Reviews and Meta-analyses has been followed. PROSPERO registration Number: CRD42016038833. Results: In total, 21 papers (20 studies) were analysed, representing a population of 12,018 persons with T2DM. For the primary outcome, HbA 1 c, the overall reduction obtained was −0.29%, decreasing the effect in long-term follow-up. The quality of the evidence was low/very low due to very serious risk of bias, inconsistency and indirectness of results. Better results were obtained for individual randomised trials versus cluster designs and in those programmes in which nurses leaded the interventions. The findings for other cardiovascular risk factors were inconsistent.Conclusions: Educational interventions in primary care addressing T2DM could be effective for metabolic control, but the low quality of the evidence and the lack of measurement of critical results generates uncertainty and highlights the need for high-quality trials.

Factors affecting glycemic control among Egyptian people with diabetes attending primary health care facilities in Mansoura District

“…The chief drive for diabetes care is not only the availability and adequacy of the health care workforce but the level of knowledge and skills needed for caring for the subjects. This because not all health care workers know about diabetes care, rather it necessitates special trainings and mentoring by experienced health providers [13].…”

Effectiveness of a Diabetes Education Program based on Tailored interventions and Theory of Planned Behaviour: Cluster randomized controlled trial protocol

“…To this end, we searched the PubMed, CINAHL, Web of Science, and Cochrane databases for relevant RCTs. The search strategy, the results obtained (with meta‐analysis), the degree of quality of the evidence (GRADE system), and the description of each intervention considered have been presented in a systematic review (Caro‐Bautista et al., 2020).…”

“…This variability makes it very difficult for a given program to be replicable with the same characteristics in different populations. Furthermore, these studies show significant methodological weaknesses, present a high risk of bias and are subject to inconsistency and indirectness in the results obtained (Caro‐Bautista et al., 2020). These shortcomings greatly limit the scope for transferring experimental results to clinical practice.…”

Development of a salutogenic intervention for healthy eating among Dutch type 2 diabetes mellitus patients

“…Studies have shown that the total energy intake, rather than the macro-nutrient composition of diets, has the most impact on glycaemic control, weight loss and cardiovascular risk factors ( Neuenschwander et al , 2019 ; Pan et al , 2019 ; Schwingshackl et al , 2018 ). Nutritional therapy has impressive effects in controlled research settings, but in everyday-life things are more complex; previous T2DM interventions using diet only resulted in small declines in weight and glycaemic blood markers ( Caro-Bautista et al , 2020 ; Coster and Norman, 2009 ; Franz et al , 2015 ; Norris et al , 2005 ), and sustaining health effects appears to be even more difficult ( Coster and Norman, 2009 ; Franz et al , 2007 , 2015 ; Turk et al , 2009 ).…”