Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials
Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials
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DOI：
10.2337/dc16-0346
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发表时间：
2016-11-01
期刊：
影响因子：
16.2
通讯作者：
Mayors, Sharon
中科院分区：
文献类型：
--
作者：
Hou, Can;Carter, Ben;Mayors, Sharon
研究设计和方法从5个数据库中检索1996年1月1日至2015年6月1日期间发表的相关研究：Medline、CINAHL、科克伦Library、Web of Science和Embase。包括评估糖尿病应用程序的随机对照试验。我们对14项研究（n = 1，360）的参与者进行了荟萃分析和GRADE（推荐评估、发展和评价分级）证据的系统评价。尽管可能存在临床多样性，但所有2型糖尿病研究均报告HbA（1c）降低。与对照组相比，使用应用程序的参与者平均减少0.49%（95% CI 0.30，0.68; I-2 = 10%），证据等级为中等。亚组分析表明，年轻患者更有可能从糖尿病应用程序的使用中受益，并且通过医疗保健专业人员的反馈增强了效应量。有不充分的数据来描述应用程序的有效性为1型diabetes.CONCLUSIONSApps可能是一个有效的组成部分，以帮助控制HbA（1c），并可以被认为是一个辅助干预的标准自我管理的2型糖尿病患者。考虑到报告的临床效果，获取和该技术的名义成本，它可能在人群水平上有效。这项技术的功能和使用需要标准化，但政策和指导预计将改善糖尿病自我管理护理。
OBJECTIVETo investigate the effect of mobile phone applications (apps) on glycemic control (HbA(1c)) in the self-management of diabetes.RESEARCH DESIGN AND METHODSRelevant studies that were published between 1 January 1996 and 1 June 2015 were searched from five databases: Medline, CINAHL, Cochrane Library, Web of Science, and Embase. Randomized controlled trials that evaluated diabetes apps were included. We conducted a systematic review with meta-analysis and GRADE (Grading of Recommendations Assessment, Development and Evaluation) of the evidence.RESULTSParticipants from 14 studies (n = 1,360) were included and quality assessed. Although there may have been clinical diversity, all type 2 diabetes studies reported a reduction in HbA(1c). The mean reduction in participants using an app compared with control was 0.49% (95% Cl 0.30, 0.68; I-2 = 10%), with a moderate GRADE of evidence. Subgroup analyses indicated that younger patients were more likely to benefit from the use of diabetes apps, and the effect size was enhanced with health care professional feedback. There was inadequate data to describe the effectiveness of apps for type 1 diabetes.CONCLUSIONSApps may be an effective component to help control HbA(1c) and could be considered as an adjuvant intervention to the standard self-management for patients with type 2 diabetes. Given the reported clinical effect, access, and nominal cost of this technology, it is likely to be effective at the population level. The functionality and use of this technology need to be standardized, but policy and guidance are anticipated to improve diabetes self-management care.