Efficacy of Nurse-Led Digitalized Diabetes Management Program for Community-Dwelling Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship Pub Date : 2025-06-03 DOI:10.1111/jnu.70022

Makhfudli Makhfudli, Ferry Efendi, Rifky Octavia Pradipta, Amatus Yudi Ismanto, Mei-Chan Chong, Santo Imanuel Tonapa

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引用次数: 0

Abstract

Purpose

Despite evidence supporting nurse-led digitalized diabetes interventions, gaps persist in understanding their specific impact on community-dwelling patients with type 2 diabetes mellitus (T2DM). Prior reviews lacked a quantitative synthesis of these interventions' effects on outcomes like self-care, HbA1c, and quality of life (QoL), limiting their applicability to clinical practice. This study aimed to systematically evaluate and quantify the effectiveness of nurse-led digitalized diabetes management programmes for community-dwelling adults with T2DM.

Methods

We searched six databases to identify relevant articles from their inception to June 2024. Randomized controlled trials that evaluate the effects of nurse-led digitalized diabetes management programs for community-dwelling patients with T2DM were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise the included studies. The pairwise meta-analysis was performed through the software Comprehensive Meta-Analysis Version 3.0.

Results

Eleven RCTs were included, encompassing 2943 participants from various regions. Nurse-led digitalized programs significantly improved self-care behaviors (SMD = 1.15; 95% CI: 0.49 to 1.81), and QoL (SMD = 0.65; 95% CI: 0.37 to 0.94). The interventions also demonstrated a clinically meaningful reduction in HbA1c levels (MD = -0.25%; 95% CI: −0.43 to −0.06), highlighting their potential in improving glycaemic control. Heterogeneity across studies was substantial for self-care but moderate for HbA1c and QoL.

Conclusions

Nurse-led digitalised diabetes management programmes effectively enhance self-care behavior, reduce HbA1c levels, and improve QoL among community-dwelling patients with T2DM. These findings underscore the potential of digitalised interventions as scalable and accessible alternatives to traditional diabetes management, particularly in non-institutionalized settings.

Clinical Relevance

Nurse-led digitalised diabetes management programmes can empower community-dwelling patients with T2DM to achieve better health outcomes by enhancing self-care and glycaemic control while improving QoL. Their integration into routine clinical practice could address barriers to care, optimize diabetes management, and reduce the long-term burden of the disease.

Review Registration

The International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024594874

Abstract Image

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护士主导的数字化糖尿病管理项目对社区2型糖尿病患者的疗效：系统回顾和meta分析。

目的：尽管有证据支持护士主导的数字化糖尿病干预，但在了解其对社区2型糖尿病（T2DM）患者的具体影响方面仍然存在差距。先前的综述缺乏对这些干预措施对自我护理、糖化血红蛋白和生活质量（QoL）等结果影响的定量综合，限制了它们在临床实践中的适用性。本研究旨在系统地评估和量化护士主导的数字化糖尿病管理项目对社区居住的成人2型糖尿病患者的有效性。方法：检索6个数据库，检索自建库至2024年6月的相关文献。纳入了评估护士主导的数字化糖尿病管理项目对社区2型糖尿病患者效果的随机对照试验。采用Cochrane风险偏倚工具2.0版对纳入的研究进行评价。两两荟萃分析采用综合荟萃分析3.0版软件进行。结果：纳入11项随机对照试验，包括来自不同地区的2943名受试者。护士主导的数字化项目显著改善了自我护理行为(SMD = 1.15；95% CI: 0.49 ~ 1.81)，生活质量(SMD = 0.65；95% CI: 0.37 ~ 0.94)。干预还显示HbA1c水平有临床意义的降低(MD = -0.25%；95% CI: -0.43至-0.06)，突出了它们在改善血糖控制方面的潜力。各研究在自我护理方面存在显著异质性，但在糖化血红蛋白和生活质量方面存在中度异质性。结论：护士主导的数字化糖尿病管理方案有效地提高了社区居住T2DM患者的自我护理行为，降低了HbA1c水平，改善了生活质量。这些发现强调了数字化干预措施作为传统糖尿病管理的可扩展和可获得的替代方案的潜力，特别是在非机构环境中。临床意义：护士主导的数字化糖尿病管理项目可以通过加强自我保健和血糖控制，同时改善生活质量，使社区2型糖尿病患者获得更好的健康结果。将它们整合到常规临床实践中可以解决护理障碍，优化糖尿病管理，并减少疾病的长期负担。综述注册：国际前瞻性系统综述注册（PROSPERO）标识符：CRD42024594874。

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来源期刊

Journal of Nursing Scholarship 医学-护理

CiteScore

6.30

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.