Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
BackgroundRemotely delivered interventions may be more efficient in controlling multiple risk factors in people with diabetes.PurposeTo pool evidence from randomized controlled trials testing remote management interventions to simultaneously control blood pressure, blood glucose and lipids.Data Sour...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.848695/full |
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| author | Malindu E. Fernando Malindu E. Fernando Malindu E. Fernando Leonard Seng Aaron Drovandi Aaron Drovandi Benjamin J. Crowley Jonathan Golledge Jonathan Golledge Jonathan Golledge Jonathan Golledge |
| author_facet | Malindu E. Fernando Malindu E. Fernando Malindu E. Fernando Leonard Seng Aaron Drovandi Aaron Drovandi Benjamin J. Crowley Jonathan Golledge Jonathan Golledge Jonathan Golledge Jonathan Golledge |
| author_sort | Malindu E. Fernando |
| collection | DOAJ |
| description | BackgroundRemotely delivered interventions may be more efficient in controlling multiple risk factors in people with diabetes.PurposeTo pool evidence from randomized controlled trials testing remote management interventions to simultaneously control blood pressure, blood glucose and lipids.Data SourcesPubMed/Medline, EMBASE, CINAHL and the Cochrane library were systematically searched for randomized controlled trials (RCTs) until 20th June 2021.Study SelectionIncluded RCTs were those that reported participant data on blood pressure, blood glucose, and lipid outcomes in response to a remotely delivered intervention.Data ExtractionThree authors extracted data using a predefined template. Primary outcomes were glycated hemoglobin (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), systolic and diastolic blood pressure (SBP & DBP). Risk of bias was assessed using the Cochrane collaboration RoB-2 tool. Meta-analyses are reported as standardized mean difference (SMD) with 95% confidence intervals (95%CI).Data SynthesisTwenty-seven RCTs reporting on 9100 participants (4581 intervention and 4519 usual care) were included. Components of the remote management interventions tested were identified as patient education, risk factor monitoring, coaching on monitoring, consultations, and pharmacological management. Comparator groups were typically face-to-face usual patient care. Remote management significantly reduced HbA1c (SMD -0.25, 95%CI -0.33 to -0.17, p<0.001), TC (SMD -0.17, 95%CI -0.29 to -0.04, p<0.0001), LDL-c (SMD -0.11, 95%CI -0.19 to -0.03, p=0.006), SBP (SMD -0.11, 95%CI -0.18 to -0.04, p=0.001) and DBP (SMD -0.09, 95%CI -0.16 to -0.02, p=0.02), with low to moderate heterogeneity (I²= 0 to 75). Twelve trials had high risk of bias, 12 had some risk and three were at low risk of bias.LimitationsHeterogeneity and potential publication bias may limit applicability of findings.ConclusionsRemote management significantly improves control of modifiable risk factors.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258433], identifier PROSPERO (CRD42021258433). |
| first_indexed | 2024-04-13T23:54:08Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-13T23:54:08Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-f40184f4db484fad8bdbb5dd317666e12022-12-22T02:23:59ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-03-011310.3389/fendo.2022.848695848695Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsMalindu E. Fernando0Malindu E. Fernando1Malindu E. Fernando2Leonard Seng3Aaron Drovandi4Aaron Drovandi5Benjamin J. Crowley6Jonathan Golledge7Jonathan Golledge8Jonathan Golledge9Jonathan Golledge10Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, AustraliaUlcer and Wound Healing Consortium (UHEAL), Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, AustraliaFaculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, NSW, AustraliaQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, AustraliaQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, AustraliaUlcer and Wound Healing Consortium (UHEAL), Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, AustraliaQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, AustraliaQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, AustraliaUlcer and Wound Healing Consortium (UHEAL), Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, AustraliaAustralian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, AustraliaDepartment of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD, AustraliaBackgroundRemotely delivered interventions may be more efficient in controlling multiple risk factors in people with diabetes.PurposeTo pool evidence from randomized controlled trials testing remote management interventions to simultaneously control blood pressure, blood glucose and lipids.Data SourcesPubMed/Medline, EMBASE, CINAHL and the Cochrane library were systematically searched for randomized controlled trials (RCTs) until 20th June 2021.Study SelectionIncluded RCTs were those that reported participant data on blood pressure, blood glucose, and lipid outcomes in response to a remotely delivered intervention.Data ExtractionThree authors extracted data using a predefined template. Primary outcomes were glycated hemoglobin (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), systolic and diastolic blood pressure (SBP & DBP). Risk of bias was assessed using the Cochrane collaboration RoB-2 tool. Meta-analyses are reported as standardized mean difference (SMD) with 95% confidence intervals (95%CI).Data SynthesisTwenty-seven RCTs reporting on 9100 participants (4581 intervention and 4519 usual care) were included. Components of the remote management interventions tested were identified as patient education, risk factor monitoring, coaching on monitoring, consultations, and pharmacological management. Comparator groups were typically face-to-face usual patient care. Remote management significantly reduced HbA1c (SMD -0.25, 95%CI -0.33 to -0.17, p<0.001), TC (SMD -0.17, 95%CI -0.29 to -0.04, p<0.0001), LDL-c (SMD -0.11, 95%CI -0.19 to -0.03, p=0.006), SBP (SMD -0.11, 95%CI -0.18 to -0.04, p=0.001) and DBP (SMD -0.09, 95%CI -0.16 to -0.02, p=0.02), with low to moderate heterogeneity (I²= 0 to 75). Twelve trials had high risk of bias, 12 had some risk and three were at low risk of bias.LimitationsHeterogeneity and potential publication bias may limit applicability of findings.ConclusionsRemote management significantly improves control of modifiable risk factors.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258433], identifier PROSPERO (CRD42021258433).https://www.frontiersin.org/articles/10.3389/fendo.2022.848695/fullblood pressurecholesterollipidssystematic reviewtelehealth |
| spellingShingle | Malindu E. Fernando Malindu E. Fernando Malindu E. Fernando Leonard Seng Aaron Drovandi Aaron Drovandi Benjamin J. Crowley Jonathan Golledge Jonathan Golledge Jonathan Golledge Jonathan Golledge Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Frontiers in Endocrinology blood pressure cholesterol lipids systematic review telehealth |
| title | Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Effectiveness of Remotely Delivered Interventions to Simultaneously Optimize Management of Hypertension, Hyperglycemia and Dyslipidemia in People With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | effectiveness of remotely delivered interventions to simultaneously optimize management of hypertension hyperglycemia and dyslipidemia in people with diabetes a systematic review and meta analysis of randomized controlled trials |
| topic | blood pressure cholesterol lipids systematic review telehealth |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.848695/full |
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