Jacintha Hui Ting Tay1, Ying Jiang2, Jingfang Hong3, Honggu He4, Wenru Wang5. 1. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: e0035632@u.nus.edu. 2. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: nurjiy@nus.edu.sg. 3. School of Nursing, Anhui Medical University, China. Electronic address: hongjingfang@ahmu.edu.cn. 4. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: nurhhg@nus.edu.sg. 5. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore. Electronic address: nurww@nus.edu.sg.
Abstract
BACKGROUND: Diabetes is a debilitating health condition that is rapidly increasing in prevalence globally. Diabetes self-management is known as an important aspect of diabetes care, and group-based self-management interventions led by lay leaders have been explored previously. However, the effects of such an interventional approach to improve glycated hemoglobin (HbA1c) levels, self-efficacy, and emergency visit rates among adults with type 2 diabetes remains inconclusive. OBJECTIVES: To review and perform a meta-analysis systematically of the effectiveness of lay-led, group-based self-management interventions to improve HbA1c levels, self-efficacy, and frequency of emergency visit rates in adults with type 2 diabetes. METHODS: A systematic literature search was conducted through the following seven databases: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, SCOPUS, and Web of Science. Screening and assessment for risk of bias were conducted by two independent reviewers. Meta-analyses were performed for HbA1c levels, self-efficacy, and frequency of emergency visits, using RevMan 5.3 software. RESULTS: Sixteen randomized controlled trials were included in this review. Meta-analyses results indicated significant effects on HbA1c (pooled MD = 0.23, 95% CI [-0.41, -0.05], p = 0.01) self-efficacy (d = 0.27; 95% CI [0.19, 0.36]; p <0.00001), and frequency of emergency visits (pooled MD = 0.15; 95% CI [-0.26, -0.05]; p = 0.004], favoring the intervention groups. However, possible publication bias was detected. Significant heterogeneity was observed for HbA1c but not for self-efficacy or frequency of emergency visits. CONCLUSIONS: Possible effects of lay-led, group-based self-management interventions on improving HbA1c, self-efficacy, and frequency of emergency visits among adults with type 2 diabetes were demonstrated in this review. Although possible publication bias and heterogeneity were detected for HbA1c, the results point toward a potentially feasible and effective treatment for adults with type 2 diabetes, allowing them to manage and sustain self-care behaviors.
BACKGROUND:Diabetes is a debilitating health condition that is rapidly increasing in prevalence globally. Diabetes self-management is known as an important aspect of diabetes care, and group-based self-management interventions led by lay leaders have been explored previously. However, the effects of such an interventional approach to improve glycated hemoglobin (HbA1c) levels, self-efficacy, and emergency visit rates among adults with type 2 diabetes remains inconclusive. OBJECTIVES: To review and perform a meta-analysis systematically of the effectiveness of lay-led, group-based self-management interventions to improve HbA1c levels, self-efficacy, and frequency of emergency visit rates in adults with type 2 diabetes. METHODS: A systematic literature search was conducted through the following seven databases: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, SCOPUS, and Web of Science. Screening and assessment for risk of bias were conducted by two independent reviewers. Meta-analyses were performed for HbA1c levels, self-efficacy, and frequency of emergency visits, using RevMan 5.3 software. RESULTS: Sixteen randomized controlled trials were included in this review. Meta-analyses results indicated significant effects on HbA1c (pooled MD = 0.23, 95% CI [-0.41, -0.05], p = 0.01) self-efficacy (d = 0.27; 95% CI [0.19, 0.36]; p <0.00001), and frequency of emergency visits (pooled MD = 0.15; 95% CI [-0.26, -0.05]; p = 0.004], favoring the intervention groups. However, possible publication bias was detected. Significant heterogeneity was observed for HbA1c but not for self-efficacy or frequency of emergency visits. CONCLUSIONS: Possible effects of lay-led, group-based self-management interventions on improving HbA1c, self-efficacy, and frequency of emergency visits among adults with type 2 diabetes were demonstrated in this review. Although possible publication bias and heterogeneity were detected for HbA1c, the results point toward a potentially feasible and effective treatment for adults with type 2 diabetes, allowing them to manage and sustain self-care behaviors.
Authors: K Majjouti; L Küppers; A Thielmann; M Redaélli; F Vitinius; C Funke; I van der Arend; L Pilic; M Hessbrügge; S Stock; B Weltermann; D Wild Journal: BMC Prim Care Date: 2022-08-31
Authors: Julia Mueller; Amy L Ahern; Stephen J Sharp; Rebecca Richards; Jack M Birch; Alan Davies; Simon J Griffin Journal: BMJ Open Date: 2022-01-31 Impact factor: 2.692