Effectiveness of IT-based diabetes management interventions: a review of the literature
Effectiveness of IT-based diabetes management interventions: a review of the literature
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DOI：
10.1186/1471-2296-10-72
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发表时间：
2009-11-17
影响因子：
2.9
通讯作者：
Dunning, Trisha A. M.
中科院分区：
文献类型：
--
作者：
Costa, Beth M.;Fitzgerald, Kristine J.;Dunning, Trisha A. M.
背景：信息技术（IT）越来越多地被用于一般实践管理卫生保健，包括2型糖尿病。然而，关于信息技术是否能改善糖尿病的预后，存在相互矛盾的证据。这篇关于基于信息技术的糖尿病管理干预的文献综述探讨了方法学问题，如样本特征、结果测量和导致结果测量变化的机制是否可以解释一些基于信息技术的糖尿病管理研究中明显的不一致的发现。方法：使用与IT和糖尿病管理相关的术语检索数据库。有资格纳入综述的文章评价了基于it的糖尿病管理干预在一般实践中的应用，发表于1999年至2009年（含英文）之间。不包括结果测量的研究被排除在外。结果：确定了425篇文章，其中16篇符合纳入标准：评估了11篇以全科医生为重点的干预措施和5篇以患者为重点的干预措施。9项为随机对照试验，5项为非随机对照试验，2项为单样本前后设计。重要的样本特征，如糖尿病类型、对信息技术的熟悉程度和糖尿病的基线知识在任何研究中都没有涉及。所有研究都使用HbA（1c）作为主要结局指标，9项研究报告在研究期间平均HbA（1c）有显著改善；只有两项研究报道了HbA（1c）测定方法。五项研究测量了糖尿病药物，两项研究测量了心理结果。患者的生活方式变量没有包括在任何研究中。IT被认为是影响结果测量变化的干预方法。只有两项研究提到了其他可能的因果机制。结论：一些局限性可能在未知程度上影响基于it的糖尿病管理干预的结果。这些限制使得很难将变化完全归因于这些干预措施。
Background: Information technology (IT) is increasingly being used in general practice to manage health care including type 2 diabetes. However, there is conflicting evidence about whether IT improves diabetes outcomes. This review of the literature about IT-based diabetes management interventions explores whether methodological issues such as sample characteristics, outcome measures, and mechanisms causing change in the outcome measures could explain some of the inconsistent findings evident in IT-based diabetes management studies.Methods: Databases were searched using terms related to IT and diabetes management. Articles eligible for review evaluated an IT-based diabetes management intervention in general practice and were published between 1999 and 2009 inclusive in English. Studies that did not include outcome measures were excluded.Results: Four hundred and twenty-five articles were identified, sixteen met the inclusion criteria: eleven GP focussed and five patient focused interventions were evaluated. Nine were RCTs, five non-randomised control trials, and two single-sample before and after designs. Important sample characteristics such as diabetes type, familiarity with IT, and baseline diabetes knowledge were not addressed in any of the studies reviewed. All studies used HbA(1c) as a primary outcome measure, and nine reported a significant improvement in mean HbA(1c) over the study period; only two studies reported the HbA(1c) assay method. Five studies measured diabetes medications and two measured psychological outcomes. Patient lifestyle variables were not included in any of the studies reviewed. IT was the intervention method considered to effect changes in the outcome measures. Only two studies mentioned alternative possible causal mechanisms.Conclusion: Several limitations could affect the outcomes of IT-based diabetes management interventions to an unknown degree. These limitations make it difficult to attribute changes solely to such interventions.