摘要
目的应用系统综述的方法,评价通过智能手机进行糖尿病自我管理干预的降血糖效果。方法通过计算机检索Pub Med、Cochrane图书馆、EMBASE、CNKI数据库、维普数据库、万方数据库,收集截至2016年6月发表的所有应用智能手机进行糖尿病自我管理干预的随机对照研究,并以糖化血红蛋白作为评价指标进行Meta分析。采用R语言Meta分析包运用加权均数差进行评价指标的合并、敏感性分析、发表偏倚分析。结果共有25个研究纳入分析,共有2 537位患者,其中干预组1 277人,对照组1 260人。监测和反馈是现有智能手机干预的主要内容。Meta分析结果显示:与常规管理相比较,通过智能手机进行糖尿病自我管理干预降糖化血红蛋白的加权均数差=-0.63(95%可信区间-0.88^-0.39,P<0.001)。亚组分析结果显示,糖尿病类型、年龄和随访时间对降低糖化血红蛋白没有影响。结论与常规管理相比较,通过智能手机进行糖尿病自我管理干预可获得较好的降低糖化血红蛋白的效果,可作为现有干预模式的补充。
Objective To compare effect of smartphone self-management intervention （SSMI）with usual care （UC） among patients with diabetes by systematic review and meta-analysis. Methods Eligible randomized controlled trials comparing SSMI with UC were searched from PubMed, The Cochrane Library, Web of Science, CNKI database, Wanfang database and VIP database until 30 June 2016. Meta-analyses were conducted to evaluate the clinical effect of HbAlc of SSMI vs. UC. Meta package of R language was used to conducted synthesizingdata （weighted mean difference, WMD） , sensitivity analysis, publication bias analysis. Results There were 2 537 patients including 1 277 in SMMI groups and 1 260 in UC groups involved in 25 studies which were included in the meta-analysis. Self-monitoring and feedback were the main components of SSMI. Compared with UC, SMMI reduced HbAIo more -0.63（95%CI -0.88--0.39, P〈0.001 ）. Subgroup analyses indicated that the effect sizes were not different among diabetes type, age and follow-up time respectively. Conclusion Compared with usual care, smartphone self-management intervention has better reducing HbA1c effect, which should be a supplementary model of usual care and community-based self-management intervention.
出处
《循证医学》
CSCD
2017年第2期95-104,共10页
The Journal of Evidence-Based Medicine
基金
上海卫生系统先进适宜技术推广资助项目(2013SY006)
关键词
糖尿病
自我管理
移动健康
META分析
diabetes mellitus
self-management
mobile health
meta-analysis
