Effectiveness of Telemedicine on Diabetes Management at Primary Care Settings in the Asian Population: A Systematic Review and Meta-Analysis.

Abstract

The number of diabetic patients has tripled over the past 20 years. To address diabetes, multicomponent intervention may prove to make a significant difference. This study was conducted to assess the effectiveness of telemedicine in diabetes management at Primary Care Centres in the Asian population and to compare the effectiveness of different strategies of telemedicine interventions. Randomized controlled trials conducted in primary health care settings examining the effectiveness of telemedicine interventions in the management of diabetics were included in this review. The search strategy included MeSH terms related to Diabetes, Telemedicine, Diabetic management, Effectiveness, and Asia to find relevant studies. The published literatures were searched on the electronic database search engines, namely, Pubmed, Embase, Scopus, and Cochrane Library. The outcomes assessed for this study were HbA1c, FBG, Psychological Distress, and Quality of Life. For metaanalysis, Cochrane's Q statistic and inconsistency index (I2) were used to compute the statistical heterogeneity. The different types of telemedicine strategies were compared and ranked by the surface under the cumulative ranking curve. Nine articles were selected based on the inclusion and exclusion criteria. Our meta analysis of eight trials indicated a significant reduction of HbA1c of 0.19% (95% CI: 0.37, 0.01; P = 0.04) compared with the control groups. The effect of telemedicine intervention favored toward the intervention group compared with the usual care group. Telemedicine can be seen as a favorable approach to manage diabetes in primary care settings.