Abstract
BackgroundInformation technology (IT) is increasingly being used in general practice to manage health care including type 2 diabetes. However, there is conflicting evidence about whether IT improves diabetes outcomes. This review of the literature about IT-based diabetes management interventions explores whether methodological issues such as sample characteristics, outcome measures, and mechanisms causing change in the outcome measures could explain some of the inconsistent findings evident in IT-based diabetes management studies.MethodsDatabases were searched using terms related to IT and diabetes management. Articles eligible for review evaluated an IT-based diabetes management intervention in general practice and were published between 1999 and 2009 inclusive in English. Studies that did not include outcome measures were excluded.ResultsFour hundred and twenty-five articles were identified, sixteen met the inclusion criteria: eleven GP focussed and five patient focused interventions were evaluated. Nine were RCTs, five non-randomised control trials, and two single-sample before and after designs. Important sample characteristics such as diabetes type, familiarity with IT, and baseline diabetes knowledge were not addressed in any of the studies reviewed. All studies used HbA1c as a primary outcome measure, and nine reported a significant improvement in mean HbA1c over the study period; only two studies reported the HbA1c assay method. Five studies measured diabetes medications and two measured psychological outcomes. Patient lifestyle variables were not included in any of the studies reviewed. IT was the intervention method considered to effect changes in the outcome measures. Only two studies mentioned alternative possible causal mechanisms.ConclusionSeveral limitations could affect the outcomes of IT-based diabetes management interventions to an unknown degree. These limitations make it difficult to attribute changes solely to such interventions.
Highlights
Information technology (IT) is increasingly being used in general practice to manage health care including type 2 diabetes
Two articles were based on a single intervention as part of the American Longitudinal Informatics for Diabetes Education and Telemedicine (IDEATel) Project, and separately examined psychological [19] and physiological [18] outcomes
Fourteen studies were conducted in the United States of America, one in the United Kingdom, and one in Korea
Summary
Information technology (IT) is increasingly being used in general practice to manage health care including type 2 diabetes. There is conflicting evidence about whether IT improves diabetes outcomes. Recent advances in Information Technology (IT) have been used to manage chronic diseases including diabetes mellitus. IT can enhance communication among health professionals (HPs) and patients [1], and improve diabetes management [2]. Type 2 diabetes mellitus is a chronic progressive disease associated with long term complications and high morbidity and mortality rates [4]. Type 2 diabetes accounts for 85% to 96% of all diagnosed cases and is reported to be largely due to lifestyle factors such as calorie dense diets, obesity and inactivity [5]
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