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Meta-Analysis
. 2022 Sep 15;14(18):3807.
doi: 10.3390/nu14183807.

Effectiveness of Therapeutic Patient Education Interventions in Obesity and Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jorge C Correia  1 , Ahmed Waqas  2 , Teoh Soo Huat  3 , Karim Gariani  1 , François R Jornayvaz  1 , Alain Golay  1 , Zoltan Pataky  1
Affiliations
Meta-Analysis

Effectiveness of Therapeutic Patient Education Interventions in Obesity and Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jorge C Correia et al. Nutrients. .

Abstract

Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis present a critical synthesis of the development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus qualitatively synthesized. Out of these, 47 were included in the quantitative synthesis. There was substantial heterogeneity in the reporting of these outcomes (I2 = 88.35%, Q = 317.64), with a significant improvement noted in serum HbA1c levels (standardized mean difference (SMD) = 0.272, 95% CI: 0.118 to 0.525, n = 7360) and body weight (SMD = 0.526, 95% CI: 0.205 to 0.846, n = 1082) in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (p < 0.001). These interventions should be implemented in healthcare and community settings to improve the health outcomes in patients suffering from obesity and DM.

Keywords: diabetes mellitus; disease management; meta-analysis; obesity; patient education; self-management.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart for selection of eligible studies.
Figure 2
Figure 2
Delivery techniques for TPE interventions.
Figure 3
Figure 3
Content and skills for development of TPE interventions.
Figure 4
Figure 4
Effectiveness of TPE interventions in improving serum HbA1c levels among patients with diabetes mellitus. The black blocks present point estimates and 95% confidence intervals for individual studies. The red block presents pooled effect size and associated 95% confidence intervals [5,9,28,29,31,35,37,40,41,42,43,46,49,51,52,54,58,59,62,63,70].
Figure 5
Figure 5
Publication bias in reporting of serum HbA1c levels outcome.
Figure 6
Figure 6
Effectiveness of TPE interventions in improving body weight among patients with obesity. The black blocks present point estimates and 95% confidence intervals for individual studies. The red block presents pooled effect size and associated 95% confidence intervals [25,39,55,64,66].
Figure 7
Figure 7
Publication bias in reporting of serum HbA1c levels outcome.
Figure 8
Figure 8
Summary graph for risk of bias among included RCTs.
See this image and copyright information in PMC

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