Abstract
BackgroundDepression is a common comorbidity in type 2 diabetes. Studies have consistently shown that major depression is associated with decreased diabetic self-care behaviour. People with subthreshold depression experience greater functional impairment, have a poorer quality of life and use health services more than those without depressive symptoms. Although subthreshold depression impacts self-care behaviour, the relationship between subthreshold depression and diabetes self-care behaviour has not been systematically reviewed. The objective of this systematic review is to determine the association between subthreshold depression and self-care behaviour in adults with type 2 diabetes.MethodsThis protocol will follow the guideline of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 (PRISMA-P-2015). A systematic search of literature will be conducted for observational studies reporting the association between subthreshold depression and self-care behaviour in adults aged 18 years or over and diagnosed with type 2 diabetes. Electronic databases including MEDLINE, EMBASE, PsycINFO, Emcare and CINAHL will be searched using predefined search terms. Title and abstract, full-text screening and data extraction of identified articles will be done by two reviewers independently. Discrepancies will be resolved by a third author. The methodological quality of the included studies will be assessed using The Joanna Briggs Institute (JBI) risk of bias tools. The review results will be presented in the form of narrative synthesis, and if sufficient studies are available and variability among the studies is low, a random effects meta-analysis will be done to quantify the result.DiscussionThis review will synthesise evidence on the association between subthreshold depression and self-care behaviour in type 2 diabetic adults. The findings will be useful to researchers and policymakers to determine the most effective approach to overall diabetes management. The review will also identify research gaps in the current literature and provide direction for future research in this area of study.Systematic review registrationPROSPERO CRD42018116373
Highlights
Depression is a common comorbidity in type 2 diabetes and affects about 10–30% of adults with diabetes [2]
Subthreshold depression is a common comorbidity among type 2 diabetic patients
We intend to determine the relationship between subthreshold depression and self-care behaviour among type 2 diabetic people
Summary
This protocol complies with the guideline of the Preferred Reporting Items for Systematic Review and MetaAnalysis Protocols 2015 (PRISMA-P-2015) [39]. The detail of the PRISMA-P checklist can be found in Additional file 1 This protocol will guide the review and any deviations while conducting the review will be reported including the reasons for the changes made in the method section of the final published manuscript. In consultation with a medical librarian experienced in systematic review database searching, a comprehensive MEDLINE (Ovid) search strategy has been developed (see Additional file 2). The following information will be extracted from the included studies: citation, country of study, aim of the study, study population characteristics (age, gender), study design (cross-sectional, case-control or cohort), study setting (community or hospital), sample size, sample size calculation, sampling technique, data source (survey or secondary data), definition of subthreshold depression, measure used (subthreshold depression, self-care behaviour), analysis, confounder variables adjusted and key observation of the study. Eggers’s regression test will be done to statistically check the asymmetry of the funnel plot
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