T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis.
T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis.
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DOI：
10.1371/journal.pone.0166718
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Nie M
中科院分区：
文献类型：
--
作者：
Cui M;Wu X;Mao J;Wang X;Nie M
基于智能手机应用程序（app）的移动的健康干预（mHealth）是帮助改善糖尿病护理和自我管理的有前途的工具;然而，需要更多关于mHealth在糖尿病护理中的功效的证据。本研究的目的是对随机对照试验（RCT）进行系统综述和荟萃分析，以评估mHealth应用程序对2型糖尿病（T2 DM）患者血红蛋白A1 c（HbA 1c）、血糖、血压、血脂和体重变化的影响。两名独立评审员检索了三个在线数据库（PubMed、科克伦图书馆和EMBASE），以识别2005年1月至2016年6月期间发表的相关研究。在检索到的2，596篇文章中，纳入了13项RCT。我们使用随机效应模型来估计合并结果。选择了13项研究进行系统性综述，其中6项包含1，022例患者的可用数据被纳入荟萃分析。基于mHealth应用程序的干预措施对血糖控制有中度影响。对HbA 1c的总体影响显示为平均差异（MD）为-0.40%（-4.37 mmol/mol）（95%置信区间[CI] -0.69至-0.11% [-7.54至-1.20 mmol/mol]; p = 0.007），标准化平均差异（SMD）为-0.40%（-4.37 mmol/mol）（95%置信区间[CI] -0.69至-0.10% [-7.54至-1.09 mmol/mol]; p = 0.008）。亚组分析显示相似的效果，-0.33%（-3.61 mmol/mol）（95% CI -0.59至-0.06% [-6.45至-0.66 mmol/mol]; p = 0.02），MD和-0.38%（-4.15 mmol/mol）（95% CI -0.71至-0.05% [-7.76至-0.55 mmol/mol]; p = 0.02）。没有发现mHealth应用程序干预对血压，血脂或体重的影响。对总体研究质量和发表偏倚的评估表明，6项研究的偏倚风险较低。智能手机应用程序为T2 DM自我管理提供了适度的益处。然而，需要更多有效的研究设计和更长时间的随访来评估移动健康应用程序对糖尿病护理和自我管理的影响。
Mobile health interventions (mHealth) based on smartphone applications (apps) are promising tools to help improve diabetes care and self-management; however, more evidence on the efficacy of mHealth in diabetes care is needed. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of mHealth apps on changes in hemoglobin A1c (HbA1c), blood glucose, blood pressure, serum lipids, and body weight in type 2 diabetes mellitus (T2DM) patients. Two independent reviewers searched three online databases (PubMed, the Cochrane Library, and EMBASE) to identify relevant studies published between January 2005 and June 2016. Of the 2,596 articles retrieved, 13 RCTs were included. We used random effects model to estimate the pooled results. Thirteen studies were selected for the systematic review, six of which with data available containing 1,022 patients were included for the meta-analysis. There was a moderate effect on glycemic control after the mHealth app-based interventions. The overall effect on HbA1c shown as mean difference (MD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.11% [-7.54 to -1.20 mmol/mol]; p = 0.007) and standardized mean differences (SMD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.10% [-7.54 to -1.09 mmol/mol]; p = 0.008). A subgroup analysis showed a similar effect with -0.33% (-3.61 mmol/mol) (95% CI -0.59 to -0.06% [-6.45 to -0.66 mmol/mol]; p = 0.02) in MD and -0.38% (-4.15 mmol/mol) (95% CI -0.71 to -0.05% [-7.76 to -0.55 mmol/mol]; p = 0.02) in SMD in studies where patients’ baseline HbA1c levels were less than 8.0%. No effects of mHealth app interventions were found on blood pressure, serum lipids, or weight. Assessment of overall study quality and publication bias demonstrated a low risk of bias among the six studies. Smartphone apps offered moderate benefits for T2DM self-management. However, more research with valid study designs and longer follow-up is needed to evaluate the impact of mHealth apps for diabetes care and self-management.
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