Home telehealth for diabetes management: a systematic review and meta-analysis
Home telehealth for diabetes management: a systematic review and meta-analysis
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DOI：
10.1111/j.1463-1326.2009.01057.x
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发表时间：
2009-10-01
影响因子：
5.8
通讯作者：
Palmer, K.
中科院分区：
文献类型：
--
作者：
Polisena, J.;Tran, K.;Palmer, K.
目的据估计，全球有超过1.8亿人患有糖尿病。卫生保健提供者可以使用信息和通信技术(也称为家庭远程保健)远程向这类患者群体提供卫生服务。家庭远程保健可分为两个子类型：家庭远程监护(HTM)和电话支持(TS)。该研究的目的是系统地回顾文献并进行荟萃分析，以评估家庭远程保健与普通护理(UC)相比对糖尿病患者的潜在益处。方法通过电子文献检索1998-2008年间发表的关于家庭远程保健和糖尿病患者的研究，检索数据库Medline、Medline in-Process&Other非索引引文、BIOSIS Previews和EMBASE。21项研究评估了HTM，5项随机对照试验评估了TS。与UC(加权平均差值=-0.21；95%可信区间-0.35至-0.08)相比，HTM对血糖控制有积极作用[以较低的糖化血红蛋白水平衡量]，但TS的结果好坏参半。研究结果表明，家庭远程保健有助于减少住院患者的数量、住院次数和卧床护理天数。在生活质量和患者满意度的研究中，家庭远程健康与UC相似或有利。结论总的来说，家庭远程健康对许多健康服务的使用和血糖控制有积极的影响。需要更多方法学质量更高的研究，以更准确地洞察家庭远程健康干预的潜在临床效果。
AimIt is estimated that more than 180 million people worldwide have diabetes. Health-care providers can remotely deliver health services to this patient population using information and communication technology, also known as home telehealth. Home telehealth may be classified into two subtypes: home telemonitoring (HTM) and telephone support (TS). The research objective was to systematically review the literature and perform meta-analyses to assess the potential benefits of home telehealth compared with usual care (UC) for patients with diabetes.MethodsAn electronic literature search was conducted to identify studies on home telehealth and patients with diabetes that were published between 1998 and 2008 using Medline, Medline In-Process & Other Non-Indexed Citations, BIOSIS Previews and EMBASE.ResultsTwenty-six studies (n = 5069 patients) on home telehealth for diabetes were selected. Twenty-one studies evaluated HTM and 5 randomized controlled trials assessed TS. HTM had a positive effect on glycaemic control [as measured by lower glycated haemoglobin level] compared with UC (weighted mean difference = -0.21; 95% confidence interval -0.35 to -0.08), but the results were mixed for TS. Study results indicated that home telehealth helps to reduce the number of patients hospitalized, hospitalizations and bed days of care. Home telehealth was similar or favourable to UC across studies for quality-of-life and patient satisfaction outcomes.ConclusionsIn general, home telehealth had a positive impact on the use of numerous health services and glycaemic control. More studies of higher methodological quality are required to give more precise insights into the potential clinical effectiveness of home telehealth interventions.