Telehealth for diabetes self-management in primary healthcare: A systematic review and meta-analysis

Abstract

Background Diabetes mellitus is prevalent worldwide and the majority of the patients with this metabolic disease are managed in primary healthcare settings. Self-management is, therefore, crucial for the health and wellbeing of people with diabetes. Due to the advancement of information technologies, telehealth intervention as self-management measures potentially offer a possible solution in the primary healthcare arena to cope with the increasing demand for diabetes control. Methods This study aims to systematically review the effectiveness of telehealth on diabetes control self-management in primary healthcare settings. A keyword search was conducted in six databases for randomised controlled trials. Data extraction and quality assessment of the reviewed studies were done with standardised forms and checklists. A meta-analysis was also performed in this review. Results Of the seven studies included in this review, all of them reported a decreasing level of glycated haemoglobin. Four studies examined the effect of telehealth interventions on fasting plasma glucose levels; however, the overall effects were insignificant. It is, nonetheless, encouraging to see two studies which investigated their effect on two-hour post-meal glucose levels, and showed positive effects for glycaemic control self-management in the short term. This finding, though only from two studies, points to a promising future of utilising telehealth interventions in controlling this metabolic disease in the primary healthcare arena. Conclusions This review showed positive effects of telehealth interventions for diabetes control self-management at the primary healthcare stage. Further studies are required to evaluate the cost-effectiveness of telehealth interventions.

Keywords: Telehealth; blood glucose; diabetes mellitus; glycaemic control; glycated haemoglobin; primary healthcare; self-management; telemedicine.