Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis.
Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis.
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DOI：
10.1136/bmjhci-2020-100291
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发表时间：
2021-04
影响因子：
4.1
通讯作者：
Iqbal U
中科院分区：
文献类型：
--
作者：
Enricho Nkhoma D;Jenya Soko C;Joseph Banda K;Greenfield D;Li YJ;Iqbal U
对干预性研究进行系统综述和荟萃分析，以研究糖尿病自我管理教育和支持（DSMES）应用程序对2型糖尿病（T2 D）患者依从性的影响。除了已识别文章和类似综述的参考文献外，还检索了PubMed、Embase、CENTRAL、Web of Science、Scopus和ProQuest。纳入了以英语报告的实验研究，评估DSMES应用程序干预与常规护理相比对T2 D患者依从性和临床结局的影响。使用科克伦偏倚风险V.2.0工具评估研究偏倚。分析计划包括叙述性综合、协调人和荟萃分析。纳入了6项随机对照试验，涉及696名参与者（平均年龄57.6岁，SD 10.59）。移动的应用程序主要用于估算临床数据、饮食摄入量或体力活动，并将信息传输给提供者。在3个月时，DSMES应用程序被证明在提高药物依从性方面有效（标准化均值差（SMD）=0.393，95% CI 0.17 - 0.61），糖化血红蛋白（HbA 1c）（平均差异（MD）=-0.314，95%CI-0.477至-0.151）和体重指数（BMI）（MD=-0.28，95%CI-0.545至-0.015）。所有合并估计值的异质性均较低（I2 0%）。四项研究有中度偏倚风险，而分别有一项被判定为低风险和高风险。与常规护理相比，DSMES应用程序对T2 D患者的药物依从性、HbA 1c和BMI有显著的小至中度影响。应用程序被描述为可靠，易于使用和方便，尽管参与者被要求精通手机。证据来自一般具有中等偏倚风险的可行性试验。需要使用基于理论的干预措施进行更长随访期的大型试验，以改善现有证据。
To conduct systematic review and meta-analysis of interventional studies to investigate the impact of diabetes self-management education and support (DSMES) apps on adherence in patients with type 2 diabetes mellitus (T2D). PubMed, Embase, CENTRAL, Web of Science, Scopus and ProQuest were searched, in addition to references of identified articles and similar reviews. Experimental studies, reported in English, assessing DSMES app intervention’s impact on adherence and clinical outcomes of patients with T2D compared with usual care were included. Study bias was assessed using Cochrane Risk of Bias V.2.0 tool. Analysis plan involved narrative synthesis, moderator and meta-analysis. Six randomised controlled trials were included, involving 696 participants (average age 57.6 years, SD 10.59). Mobile apps were mostly used for imputing clinical data, dietary intake or physical activity, and transmitting information to the provider. At 3 months, DSMES apps proved effective in improving medication adherence (standardized mean difference (SMD)=0.393, 95% CI 0.17 to 0.61), glycated haemoglobin (HbA1c) (mean difference (MD)=−0.314, 95% CI −0.477 to –0.151) and Body Mass Index (BMI) (MD=−0.28, 95% CI −0.545 to –0.015). All pooled estimates had low heterogeneity (I2 0%). Four studies had moderate risk of bias while one each was judged to be low and high risks, respectively. DSMES apps had significant small to moderate effects on medication adherence, HbA1c and BMI of patients with T2D compared with usual care. Apps were described as reliable, easy to use and convenient, though participants were required to be phone literate. Evidence comes from feasibility trials with generally moderate risk of bias. Larger trials with longer follow-up periods using theory-based interventions are required to improve current evidence.
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影响因子：
4
作者：
Hozo SP;Djulbegovic B;Hozo I
通讯作者：
Hozo I
DOI：
10.1331/japha.2013.12202
发表时间：
2013-03
期刊：
Journal of the American Pharmacists Association : JAPhA
影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
16.2
作者：
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通讯作者：
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影响因子：
4.7
作者：
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通讯作者：
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