E-health may help to improve self-care in diabetes, but more research is still needed

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E-health offers tremendous potential to improve self-management of diabetes.  The Centre for Reviews and Dissemination (CRD) has recently published an appraisal of a systematic review into the use of e-health in diabetes and other chronic conditions.

Clinical question:

In people with diabetes, do e-health interventions improve self-management?

The reviewers looked at the use of interactive websites to enable communication and education between healthcare providers and patients.  The outcomes of interest included self-care, overall health status and quality of life.

The evidence:

The reviewers found 12 RCTs, four of which compared e-health to usual care in diabetes.  No meta-analysis was possible because of the heterogeneity between studies.  However, the reviewers performed a narrative synthesis and concluded that these trials:

showed small to moderately improved health outcomes in terms of glycosylated haemoglobin.

Appraisal hints:

The Centre for Reviews and Dissemination (CRD) appraised the quality of this review and concluded:

The potential for error and bias in parts of the review process meant that a degree of caution might be required when interpreting the reliability of this review.

Specifically:

  • The literature search may have missed important unpublished trials.
  • Was there blind, independent evaluation of study quality?
  • Was there important heterogeneity between the studies?
  • The observed improvements were modest.

Reference:

Eland-de Kok P, van Os-Medendorp H, Vergouwe-Meijer A, Bruijnzeel-Koomen C, Ros W. A systematic review of the effects of e-health on chronically ill patients. Journal of Clinical Nursing 2011; 20(21/22): 2997-3010.

Get the structured abstract from the Database of Abstracts of Reviews of Effectiveness (DARE).

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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