Effects of nurse-led web-based interventions on people with type 2 diabetes mellitus: A systematic review and meta-analysis

Abstract

Introduction Diabetes mellitus is an expanding global health problem. Currently, the home management of diabetes is mainly led by a multidisciplinary team based on telemedicine. However, the role nurses play in it remains inconclusive. This study aimed to investigate the effectiveness of nurse-led web-based intervention on glycated haemoglobin, blood pressure and lipid profile in patients with type 2 diabetes. Methods An exhaustive systematic literature search was undertaken using the following databases: PubMed, Web of Science, Embase, The Cochrane Central Register of Controlled Trials and CINAHL. Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias and using Modified Jadad Score system. We conducted a meta-analysis of randomized controlled trials that had been published from inception to July 2020, using Review Manager 5.3. Results Eleven randomized controlled trials were selected that included 2063 participants. Meta-analyses results indicated significant effects on not only glycated haemoglobin (pooled mean difference (MD) = –0.40, 95% confidence interval (CI): –0.5 to –0.26, p < 0.00001), but also on systolic blood pressure (pooled MD = –1.91, 95% CI: –3.73 to –0.09, p = 0.04) and low density lipoprotein (pooled standardized MD = –0.29, 95% CI: –0.44 to –0.15, p < 0.0001). There were no effects of nurse-led web-based intervention on fasting blood glucose, diastolic blood pressure, high density lipoprotein, body mass index and triglycerides. Discussion Nurse-led web-based intervention is a promising way to complement routine clinical care. However, the specific intervention content and intervention media still need to carry out large-scale well-designed randomized controlled trials. Systematic review registration: PROSPERO CRD 42020204565.

Effects of a Nurse-Led Telehealth Self-care Promotion Program on the Quality of Life of Community-Dwelling Older Adults: Systematic Review and Meta-analysis

“…Even in studies where statistically significant findings were not observed, improvements in health outcomes such as QoL and self-efficacy were noted [ 31 ], as well as improved self-management practices [ 30 ]. A similar pattern of results was reported among persons living with cancer [ 38 ] and type 2 diabetes mellitus [ 39 ] who received nurse-led services. Taken together, the findings seem to suggest that well-designed nurse-led services delivered by trained staff may be a promising program of care that can complement and extend existing services from the health care facility to the home/community.…”

Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: a systematic review and meta-analysis

“…The lack of an effect from nurse-led interventions on LDL-c in our study was in contrast to the finding of Niu et al . 43 It might because nurses in most countries are unable to prescribe and increase titration treatments, and they rely on physicians to play this role, which may hinder the development of nursing roles. 49–51 Improvement of LDL-c needs comprehensive strategies including drugs, diet change, exercise and may not easily be changed by single intervention.…”

A Telemedicine System Intervention for Patients With Type 1 Diabetes: Pilot Feasibility Crossover Intervention Study

“…A growing number of studies discuss the influence of digital technologies on the compensation of diabetes mellitus disease [ 9 , 18 - 20 , 27 ]. Interventions are more often in the form of the use of mobile apps, web portals, email, SMS text messages, phone calls, and customized smart devices [ 6 , 9 , 27 ].…”

“…TSs have been increasingly used in the care of diabetes in the last decade [ 9 - 17 ]. Despite the benefits they offer their users [ 9 , 18 - 20 ], they have not yet been widely adopted as a tool for health care delivery [ 10 ], and the systems have not been adequate enough to meet their created plan for the care of diabetes [ 5 , 8 , 12 ]. During the recent COVID-19 pandemic, the situation generally improved.…”