Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis
The popularity of teleconsultation during the COVID-19 pandemic enabled increased accessibility for individuals with type 2 diabetes mellitus (T2DM). However, previous studies did not distinguish between synchronous and asynchronous teleconsultation. We evaluated the effectiveness of synchronous tel...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/11/1/e003180.full |
| _version_ | 1797866196701282304 |
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| author | Chunhua Chi Jianxin Zhang Kai Lin Xinxin Ji Jieying Xie Mi Yao |
| author_facet | Chunhua Chi Jianxin Zhang Kai Lin Xinxin Ji Jieying Xie Mi Yao |
| author_sort | Chunhua Chi |
| collection | DOAJ |
| description | The popularity of teleconsultation during the COVID-19 pandemic enabled increased accessibility for individuals with type 2 diabetes mellitus (T2DM). However, previous studies did not distinguish between synchronous and asynchronous teleconsultation. We evaluated the effectiveness of synchronous teleconsultation for patients with T2DM. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library and Cochrane Database of Systematic Reviews, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to July 2021. All included studies were randomized controlled trials of synchronous teleconsultation for adults with T2DM compared with usual care. Reviewers independently extracted data and used the Cochrane tool to evaluate risk of bias. Meta-analyses were conducted using random-effects models. A pooled mean difference for both HbA1c (%) and body mass index (BMI) (kg/m2), systolic blood pressure (SBP) (mm Hg), diastolic blood pressure (DBP) (mm Hg), and low density lipoprotein cholesterol (LDL-cholesterol) (mg/dL) were calculated. Patient-reported outcomes, such as depression, medication adherence, and quality of life, were also assessed. A total of 9807 abstracts were identified and 27 trials were included. Synchronous teleconsultation significantly resulted in greater decrease in HbA1c compared with usual care group (n=8746, 0.35, 95% CI 0.20 to 0.49, I2=73%, p<0.001). No significant effects on BMI (n=699, 0.08 kg/m2, 95% CI −0.54 to 0.69), SBP (n=5512, 1.32 mm Hg, 95% CI -0.09 to 2.73), DBP (n=2898, 0.17 mm Hg, 95% CI −1.18 to 1.52), or LDL-cholesterol (n=5276, 3.21 mg/dL, 95% CI −1.75 to 8.17) were found. The effect of teleconsultation in improving patient-reported outcomes was uncertain. Thus, synchronous teleconsultation could be an alternative to usual care. Systematic review registration is PROSPERO CRD42021267019. |
| first_indexed | 2024-04-09T23:20:09Z |
| format | Article |
| id | doaj.art-dececbe039d24f358fa05d60087e2ed0 |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-04-09T23:20:09Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-dececbe039d24f358fa05d60087e2ed02023-03-22T03:30:06ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972023-02-0111110.1136/bmjdrc-2022-003180Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysisChunhua Chi0Jianxin Zhang1Kai Lin2Xinxin Ji3Jieying Xie4Mi Yao5General Practice Department, Peking University First Hospital, Beijing, ChinaGeneral Practice Department, Peking University First Hospital, Beijing, ChinaFamily Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaFamily Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, ChinaEmergency department, Nanfang Hospital Southern Medical University, Guangzhou, Guangdong, ChinaGeneral Practice Department, Peking University First Hospital, Beijing, ChinaThe popularity of teleconsultation during the COVID-19 pandemic enabled increased accessibility for individuals with type 2 diabetes mellitus (T2DM). However, previous studies did not distinguish between synchronous and asynchronous teleconsultation. We evaluated the effectiveness of synchronous teleconsultation for patients with T2DM. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library and Cochrane Database of Systematic Reviews, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to July 2021. All included studies were randomized controlled trials of synchronous teleconsultation for adults with T2DM compared with usual care. Reviewers independently extracted data and used the Cochrane tool to evaluate risk of bias. Meta-analyses were conducted using random-effects models. A pooled mean difference for both HbA1c (%) and body mass index (BMI) (kg/m2), systolic blood pressure (SBP) (mm Hg), diastolic blood pressure (DBP) (mm Hg), and low density lipoprotein cholesterol (LDL-cholesterol) (mg/dL) were calculated. Patient-reported outcomes, such as depression, medication adherence, and quality of life, were also assessed. A total of 9807 abstracts were identified and 27 trials were included. Synchronous teleconsultation significantly resulted in greater decrease in HbA1c compared with usual care group (n=8746, 0.35, 95% CI 0.20 to 0.49, I2=73%, p<0.001). No significant effects on BMI (n=699, 0.08 kg/m2, 95% CI −0.54 to 0.69), SBP (n=5512, 1.32 mm Hg, 95% CI -0.09 to 2.73), DBP (n=2898, 0.17 mm Hg, 95% CI −1.18 to 1.52), or LDL-cholesterol (n=5276, 3.21 mg/dL, 95% CI −1.75 to 8.17) were found. The effect of teleconsultation in improving patient-reported outcomes was uncertain. Thus, synchronous teleconsultation could be an alternative to usual care. Systematic review registration is PROSPERO CRD42021267019.https://drc.bmj.com/content/11/1/e003180.full |
| spellingShingle | Chunhua Chi Jianxin Zhang Kai Lin Xinxin Ji Jieying Xie Mi Yao Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis BMJ Open Diabetes Research & Care |
| title | Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis |
| title_full | Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis |
| title_fullStr | Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis |
| title_full_unstemmed | Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis |
| title_short | Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis |
| title_sort | effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus a systematic review and meta analysis |
| url | https://drc.bmj.com/content/11/1/e003180.full |
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