&lt;p&gt;Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial&lt;/p&gt;

Guo, Zhiqi; Liu, Jing; Zeng, Hui; He, Guoping; Ren, Xiubao; Guo, Jia

doi:10.2147/ppa.s213645

Cited by 14 publications

(27 citation statements)

References 31 publications

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“…All pharmacist task-sharing interventions incorporated diabetes self-management education, but no trial included education alone. Seven interventions included counseling and reminders through telephone calls or text messages [34,35,38,39,41,55,57], and a study in Iran incorporated only telephone calls with no face-to-face encounters [50]. No intervention involved pharmacists independently prescribing or titrating medications.…”

Section: Plos Medicinementioning

confidence: 99%

“…Diabetes education or support alone. Nine studies involved health workers primarily implementing diabetes education or support without additional services [32,39,40,43,46,49,53,54,56]. We defined these interventions as diabetes education or support alone.…”

Section: Plos Medicinementioning

confidence: 99%

“…Six of the studies primarily involved in-person delivery [32,40,43,46,49,56], and 3 studies delivered the intervention in group format [46,49,56]. The health workers in these studies varied between and within studies and included peers [49,53,56], community health workers [43,46,53], nurses [32,39,40,53,54], psychologists [32], and physicians [32,39,54]. Face-to-face encounters were supplemented with telephone calls in 2 studies [32,54] and by computerassisted instruction in another study [40].…”

Section: Plos Medicinementioning

confidence: 99%

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Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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Background Effective health system interventions may help address the disproportionate burden of diabetes in low- and middle-income countries (LMICs). We assessed the impact of health system interventions to improve outcomes for adults with type 2 diabetes in LMICs. Methods and findings We searched Ovid MEDLINE, Cochrane Library, EMBASE, African Index Medicus, LILACS, and Global Index Medicus from inception of each database through February 24, 2020. We included randomized controlled trials (RCTs) of health system interventions targeting adults with type 2 diabetes in LMICs. Eligible studies reported at least 1 of the following outcomes: glycemic change, mortality, quality of life, or cost-effectiveness. We conducted a meta-analysis for the glycemic outcome of hemoglobin A1c (HbA1c). GRADE and Cochrane Effective Practice and Organisation of Care methods were used to assess risk of bias for the glycemic outcome and to prepare a summary of findings table. Of the 12,921 references identified in searches, we included 39 studies in the narrative review of which 19 were cluster RCTs and 20 were individual RCTs. The greatest number of studies were conducted in the East Asia and Pacific region (n = 20) followed by South Asia (n = 7). There were 21,080 total participants enrolled across included studies and 10,060 total participants in the meta-analysis of HbA1c when accounting for the design effect of cluster RCTs. Non-glycemic outcomes of mortality, health-related quality of life, and cost-effectiveness had sparse data availability that precluded quantitative pooling. In the meta-analysis of HbA1c from 35 of the included studies, the mean difference was −0.46% (95% CI −0.60% to −0.31%, I2 87.8%, p < 0.001) overall, −0.37% (95% CI −0.64% to −0.10%, I2 60.0%, n = 7, p = 0.020) in multicomponent clinic-based interventions, −0.87% (−1.20% to −0.53%, I2 91.0%, n = 13, p < 0.001) in pharmacist task-sharing studies, and −0.27% (−0.50% to −0.04%, I2 64.1%, n = 7, p = 0.010) in trials of diabetes education or support alone. Other types of interventions had few included studies. Eight studies were at low risk of bias for the summary assessment of glycemic control, 15 studies were at unclear risk, and 16 studies were at high risk. The certainty of evidence for glycemic control by subgroup was moderate for multicomponent clinic-based interventions but was low or very low for other intervention types. Limitations include the lack of consensus definitions for health system interventions, differences in the quality of underlying studies, and sparse data availability for non-glycemic outcomes. Conclusions In this meta-analysis, we found that health system interventions for type 2 diabetes may be effective in improving glycemic control in LMICs, but few studies are available from rural areas or low- or lower-middle-income countries. Multicomponent clinic-based interventions had the strongest evidence for glycemic benefit among intervention types. Further research is needed to assess non-glycemic outcomes and to study implementation in rural and low-income settings.

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Section: Plos Medicinementioning

confidence: 99%

Section: Plos Medicinementioning

confidence: 99%

Section: Plos Medicinementioning

confidence: 99%

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Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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“…Non-pharmacological inter ventions included assessment, monitoring, lifestyle education, and counselling for the management of diabetes. The interventions were delivered by pharmacists (n=16 [35%]), 41,42,44,45,[52][53][54][55][56]61,62,66,[68][69][70]73 nurses (n=19 [41%]), 31,[33][34][35][36]39,40,43,46,49,57,59,64,65,67,71,72,75,77 dietitians or nutritionists (n=4 [9%]), 47,50,58,74 community health workers (n=5 [11%]), 32,37,38,48,63 or a combination of community health centre staff, nurses, or pharmacists (n=2 [4%]). 51,60 Of the 46 trials, 37 (80%) delivered a non-pharmacological intervention, eight (17%) had both non-pharmacological and pharmacological components, 38,…”

Section: Resultsmentioning

confidence: 99%

Task-sharing interventions for improving control of diabetes in low-income and middle-income countries: a systematic review and meta-analysis

Joseph

Anand

Boban

et al. 2021

The Lancet Global Health

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Background Task-sharing interventions using non-physician health-care workers might be a potential diabetes management strategy in health systems that are constrained by physician shortages, such as those in low-income and middle-income countries (LMICs). Methods We did a systematic review and meta-analysis of task-sharing intervention strategies for managing type 2 diabetes in LMICs. We searched PubMed, Embase, and CINAHL from database inception to Sept 25, 2019, for studies that were randomised control trials or cluster randomised trials with task-shifted or task-shared interventions delivered to adults (≥18 years) by non-physician health workers versus usual care, done in LMICs with glycated haemoglobin (HbA 1c) or fasting blood sugar (FBS) as outcome measures. The methodological quality of included studies was assessed using the Cochrane risk of bias tool. Random-effects model meta-analysis was used to estimate the population average pooled mean difference for HbA 1c and FBS with 95% CIs. Our study protocol was registered in the PROSPERO database (CRD42018081015). Findings We found 4213 studies from the literature search, of which 46 (1•1%) were eligible for the narrative synthesis, including a total of 16 973 participants. 16 of these studies were excluded from the meta-analysis due to high risk of bias. 24 studies with a total of 5345 participants were included in the meta-analysis of HbA 1c and 18 studies with a total of 3287 participants for FBS. Interventions led to an average reduction in HbA 1c when tasks were delivered by nurses (averaged pooled mean difference −0•54% [95% CI −0•89 to −0•18]; I²=80%) and pharmacists (−0•91% [−1•15 to −0•68]; I²=58%), but not when they were delivered by dietitians (−0•50% [-1•10 to 0•09]; I²=54%) or community health workers (0•05% [0•03 to 0•07]; I²=0%). A reduction in average FBS was also observed when interventions were delivered by pharmacists (average pooled mean difference-36•26 mg/dL [-52•60 to-19•92]; I²=78%) but not nurses (-7•46 mg/dL [-18•44 to 3•52]; I²=79%) or community health workers (-5•41 [-12•74 to 1•92]; I²=71%). Only one study reported on FBS when tasks were delivered by dietitians, with a mean difference of-35•00 mg/dL (-65•96 to-4•04). Interpretation Task sharing interventions with non-physician healthcare workers show moderate effectiveness in diabetes management in LMIC settings. Although relatively high heterogeneity limits the interpretation of the overall findings, interventions led by pharmacists and nurses in LMICs with relatively high physician density are effective strategies in the management of diabetes.

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“…1,3 Kültürel, sosyodemografik ve coğrafi sınırları aşan 4 , yüksek engellilik ve ölüm oranına neden olan, ekonomi ve toplumun sürdürülebilir kalkınmasını etkileyen ciddi bir halk sağlığı sorunudur ve topluma ağır bir hastalık yükü getirmektedir. 5 Diyabet, 21. yüzyılın en hızlı artan sağlık sorunlarından biridir ve diyabetle yaşayan yetişkinlerin sayısı son 20 yılda üç kattan fazla artmıştır. Uluslararası Diyabet Federasyonu 9.…”

Section: Introductionunclassified

Multidisciplinary Team Approach in Diabetes Self Management

Yıldırım

Hacıhasanoğlu

Bozdemir

et al. 2020

Turkish Journal of Family Medicine and Primary Care

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Diabetes is one of the fastest growing globally, serious and costly public health problems associated with significant morbidity and mortality. It is a chronic disease that requires many decisions about complex care activities and self-management that must be done daily by patients. It is important that individuals receive adequate and effective self-management education and support in reducing and delaying complications related to diabetes. Therefore, in order to develop effective diabetes self-management knowledge and skills, it is a necessity to support individuals with interventions carried out especially in primary care under the leadership of family physicians and nurses. In this review, by considering the needs, cultural values, beliefs, education and economic status of the patient, with the multidisciplinary team approach, the main factors in understanding the health and self-management relationship in diabetes with practical, easy and accessible interventions are aimed to be objective and comprehensive offer.

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<p>Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial</p>

Cited by 14 publications

References 31 publications

Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis

Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis

Task-sharing interventions for improving control of diabetes in low-income and middle-income countries: a systematic review and meta-analysis

Multidisciplinary Team Approach in Diabetes Self Management

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