Abstract
BackgroundTelephone-delivered intervention can provide many supports in diabetes self-management to improve glycemic control. Several trials showed that telephone intervention was positively associated with glycemic outcomes in diabetes. The objective of this meta-analysis was to assess the impact of telephone contact intervention (intervention group) on glycemic control compared with standard clinical care (control group).MethodsRandomized control studies of telephone intervention in diabetes were searched on Medline (Pubmed), the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science (ISI), and Scopus. Electronic search was done from inception to April 2013. The following MeSH terms were used: diabetes mellitus, randomized control trials and telemedicine, together with keywords including phone intervention, diabetes, and glycemic control. Historical search was also conducted on the references of relevant articles. The quality of the trials was assessed using Maastricht-Amsterdam scale. Treatment effect was estimated with mean difference in the change of hemoglobin A1c (HbA1c) from baseline between the intervention and control groups.ResultsA total of 203 articles were examined. Five trials involving 953 patients met the inclusion criteria and contributed to the meta-analysis. Telephone contact intervention was no more effective than standard clinical care in improving glycemic control (pooled mean difference in HbA1c −0.38%, 95%CI −0.91 to 0.16%).ConclusionsThis meta-analysis showed that the phone contact intervention was no more effective than standard clinical care in improving glycemic control in diabetes. However, telephone intervention may still have potential benefits especially for low-and middle-income countries; thus further large sample size and well-controlled studies are needed to evaluate the impact of the intervention.
Highlights
Diabetes is a metabolic disorder that is characterized by hyperglycemia resulting from insulin deficiency, insulin resistance or both
24 studies were further excluded for the following reasons: they either used modern devices including accelerometer [17], log book [18], pedometer [19,20] and glucometer [21], or the patients participating in the study employed self-care activities including self-glucose monitoring [5,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38] and medication adjustment by patients themselves [39]
Two studies [41,42] were three-armed randomized trials in which two intervention groups were compared with the control group
Summary
Diabetes is a metabolic disorder that is characterized by hyperglycemia resulting from insulin deficiency, insulin resistance or both. Many patients fail to achieve glycemic control because of inadequate out-patient services they receive in support of self-care management. They may experience financial hardship that prevents them from regular follow-up assessment, especially in low-income countries [3,4]. Telephone-delivered intervention can provide many supports in diabetes self-management to improve glycemic control. Several trials showed that telephone intervention was positively associated with glycemic outcomes in diabetes. The objective of this meta-analysis was to assess the impact of telephone contact intervention (intervention group) on glycemic control compared with standard clinical care (control group)
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