Clinical study of transitional care intervention on patients with diabetic foot ulcer: a Meta-analysis

Abstract

Objective To observe the clinical effects of transitional care intervention on patients with diabetic foot ulcer (DFU) , so as to provide nursing evidence for clinical. Methods The literatures of randomized controlled trials (RCT) on the transitional care intervention on patients with diabetic foot ulcer were searched electronically in national and international medical databases from database created to 31st January 2017. The modified Jadad scale was used to evaluate methodological quality. Rev Man 5.3.1 software was used for the Meta-analysis. Results A total of 16 RCTs were enrolled in this Meta-analysis. The Meta-analysis showed that transitional care intervention on patients with DFU was more effectively in improving self-efficacy compared routine nursing [SMD=1.75, 95%CI (1.28, 2.22) , P<0.001], promoting the master of the hypoglycemic knowledge [SMD=1.94, 95%CI (0.79, 3.09) , P=0.001]and daily foot care knowledge [SMD=1.87, 95%CI (1.44, 2.30) , P<0.001], decreasing the fasting blood glucose [MD=-0.87, 95%CI (-1.11, -0.63) , P<0.001]and 2 hours postprandial blood glucose [MD=-1.43, 95%CI (-1.85, -1.01) , P<0.001], reducing the glycosylated hemoglobin [MD=-0.84, 95%CI (-1.41, -0.27) , P=0.004], as well as decreasing the DFU infection rate [RR=0.26, 95%CI (0.11, 0.60) , P=0.004]and DFU recurrence rate [RR=0.20, 95%CI (0.05, 0.73) , P=0.020]. Conclusions Currently, published evidence from RCTs suggests that transitional care intervention on patients with DFU is superior to conventional nursing; however, available studies are not adequate to draw a conclusion on the superiority and effectiveness of transitional care intervention on DFU due to the methodological flaws of the included trials. Hence, people could provide useful experience on further studies which are multiple centered and have big sample to confirm our findings. Key words: Diabetic foot; Transitional care; Intervention effect; Meta analysis