Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis

Chen, Dandan; Ye, Zhihong; Tang, Leiwen; Zhang, Hui; Wang, Xiyi; Zhang, Qi

doi:10.1136/bmjopen-2020-036927

Cited by 13 publications

(14 citation statements)

References 52 publications

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“…Web-based interventions (WBIs), which are defined as therapeutic programs with specific health objectives delivered using web-connected devices, seem to be an ideal mode of medical and public health practice in the era of information and communication technology revolution, as they contribute to closing the loop between patients and health care providers; realizing the vision of pervasive health care; overcoming the inequivalent distribution of medical resources; and increasing the accessibility, continuity, and efficiency of medical services [19,20]. In recent years, WBIs have drawn great attention from the medical and hygiene fields and have been widely integrated into health systems to assist in the management of various diseases [21][22][23]. Women of childbearing age are regarded as an ideal target population for the implementation of web-based technologies that improve their health, as they generally own at least 1 web-based device and have an excellent grasp of these technologies [16,24,25].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Interventions for Pregnant Women With Gestational Diabetes Mellitus: Systematic Review and Meta-analysis

Guo¹,

Chen²,

Xu³

et al. 2023

J Med Internet Res

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Background Effective management of gestational diabetes mellitus (GDM) is essential because it is one of the most prevalent diseases during pregnancy, and the consequent condition maternal hyperglycemia is closely related to considerable short- and long-term maternal and neonatal complications. Web-based interventions (WBIs), defined as therapeutic interventions offered via the web, have been implemented to assist in managing GDM owing to their advantages of high accessibility and efficiency, but findings across relevant studies are inconsistent. Objective This systematic review and meta-analysis aimed to evaluate the effectiveness of WBIs on glycemic control among pregnant women with GDM; examine whether specific types of intervention interactivity, format, and technology have beneficial effects on maternal glycemic control; and comprehensively assess the efficacy of WBIs in maternal behavioral outcomes, cognitive and attitudinal outcomes, mental health, maternal and neonatal clinical outcomes, and medical service use and costs among pregnant women with GDM. Methods PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and PsycINFO were searched from their respective inception to November 19, 2022, to identify relevant randomized controlled trials and controlled clinical trials. The methodological quality of the included studies was assessed using the Effective Public Health Practice Project tool. Where possible, the data for all outcomes were meta-analyzed using the Stata software (version 12.0; StataCorp). Overall, 3 subgroup analyses and post hoc sensitivity analyses of maternal glycemic control parameters were performed. Results Overall, 25 publications arising from 21 randomized controlled trials and controlled clinical trials were included. The overall meta-analyses on glycemic control parameters demonstrated that WBIs could significantly improve fasting blood glucose (standardized mean difference=−1.764, 95% CI −2.972 to −0.557; P=.004) and 2-hour postprandial blood glucose (standardized mean difference=−1.433, 95% CI −2.561 to −0.304; P=.01) compared with the control group, whereas no significant effect was found on glycated hemoglobin and 1-hour postprandial blood glucose. The results of the subgroup analyses indicated that mobile app–delivered interventions with a personalized format and interactive function showed more beneficial effects on maternal glycemic control. Moreover, WBIs could significantly enhance compliance with the self-monitoring of blood glucose; increase the rate of normal vaginal delivery; and decrease the chance of emergency cesarean, admission to the neonatal intensive care unit, and composite neonatal complications. GDM knowledge, risk perception of the disease, self-efficacy, satisfaction with care, and medical service use of the participants in the WBI group were also improved compared with the control group. However, the effectiveness of WBIs on other secondary outcomes was either nonsignificant or uncertain. Conclusions WBIs are a promising approach to GDM management. Personalized, interactive, and mobile app–delivered interventions seem more worthy of being recommended for future clinical practice. Further high-quality studies are required to verify these findings before making broad recommendations. Trial Registration PROSPERO CRD42022296625; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=296625

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Section: Introductionmentioning

confidence: 99%

Web-Based Interventions for Pregnant Women With Gestational Diabetes Mellitus: Systematic Review and Meta-analysis

Guo¹,

Chen²,

Xu³

et al. 2023

J Med Internet Res

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“…Digital Health interventions can be beneficial for improving systolic blood pressure and anthropometric outcomes like waist circumference. 32 Automatized follow-up and alert systems provide support for the control and reduction of diseases associated with high blood pressure. Integration of new physiological variables for monitoring is feasible, and will broaden the scope for the early detection of chronic diseases including those associated with the metabolic syndrome, which could result in a reduction in their frequency.…”

Section: Discussionmentioning

confidence: 99%

Predicting metabolic syndrome using machine learning – Analysis of commonly used indices

Avizohar,

Shehory

2023

Health Informatics J

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Determining the factors that contribute to making a reliable prediction of the metabolic syndrome will provide a deeper understanding of the medical indices involved in the prediction and assist in early diagnosis and treatment of patients. The study examined the optimal number of National cholesterol education program adult treatment panel (NCEP ATP) III indices needed to make a reliable prediction of the syndrome, whether each of the five NCEP ATP III indices for predicting the syndrome is equally important and whether a reliable prediction can be made using calculated blood pressure indices – estimated mean arterial pressure and pulse pressure – instead of NCEP ATP III blood pressure indices. The results show that NCEP ATP III indices for determination of the syndrome are not equally important. Moreover, the indices importance and their prediction quality vary according to gender. Optimal results are obtained by using all five NCEP ATP III indices for prediction.

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“…Step 2. Literature reviews : The needs assessment started with a literature review on an exploration of adaptation in chronic care ( 30 ) and electronic health interventions on lifestyle modification ( 31 ). Additionally, a scoping review about the coping strategies enacted by cardiac patients was conducted, and with the extraction of influencing factors related to coping capacity (unpublished).…”

Section: Methodsmentioning

confidence: 99%

Development of an integrated cardiac rehabilitation program to improve the adaptation level of patients after acute myocardial infarction

Wang

Lee

et al. 2023

Front. Public Health

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BackgroundIndividual’s adaptation following acute myocardial infarction (AMI) and low attendance of whole-course cardiac rehabilitation (CR) are significant issues. For optimal health post AMI, an integrated CR program aiming at individual’s adaptive behaviors is imperative for improving the CR efficiency and patients’ outcomes. This study aims to develop theory-guided interventions to increase CR attendance and adaptation level of patients post-AMI.MethodsThis study was conducted in a tertiary hospital from July 2021 to September 2022 in Shanghai China. Guided by the theory of adaptation to chronic illness (ACI theory), the study followed the Intervention mapping (IM) framework to develop the interventions for CR program. Four phases included: (1) needs assessment of patients and facilitators using a cross-sectional study and semi-structured, in-depth interviews, (2) identification of implementation outcomes and performance objectives, (3) selection of theoretical methods to explain the mechanism of patients’ adaptive behaviors and to use for behavior change, and (4) development of implementation protocol from the results of the previous phases.ResultsA total of 226 AMI patient-caregivers paired samples were eligible for the data analysis, 30 AMI patients participated in the qualitative inquiry, 16 experts in the CR field evaluated the implementation protocol, and 8 AMI patients commented on the practical interventions. Following the IM framework, an integrated cardiac rehabilitation program using mHealth strategies was developed for AMI patients to facilitate CR attendance and completion, to improve their adaptation level and health outcomes.ConclusionUsing the IM framework and ACI theory, an integrated CR program was developed to help guide the behavior change and improve adaptation among AMI patients. The preliminary findings suggest that further intervention in enhancing the combination of three-stage CR is required. A feasibility study will be conducted to assess the acceptability and effectiveness of this generated CR intervention.

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Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis

Cited by 13 publications

References 52 publications

Web-Based Interventions for Pregnant Women With Gestational Diabetes Mellitus: Systematic Review and Meta-analysis

Web-Based Interventions for Pregnant Women With Gestational Diabetes Mellitus: Systematic Review and Meta-analysis

Predicting metabolic syndrome using machine learning – Analysis of commonly used indices

Development of an integrated cardiac rehabilitation program to improve the adaptation level of patients after acute myocardial infarction

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