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.
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 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.
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.
- The literature search may have missed important unpublished trials.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.
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).