Exploring the Effectiveness of Self-Management Interventions in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

作者：Sofia Tsokani, Georgios Seitidis, Christos Christogiannis, Katerina‐Maria Kontouli, Stavros Nikolakopoulos, Stella Zevgiti, Carola Orrego, Marta Ballester, Rosa Suñol, Monique Heijmans, Rune Poortvliet, Marieke van der Gaag, Pablo Alonso‐Coello, Carlos Canelo‐Aybar, Jessica Beltrán, Ana Isabel González-González, Gimon de Graaf, Areti-Angeliki Veroniki, Dimitris Mavridis · 发表于：Healthcare · 年份：2023 · DOI：10.3390/healthcare12010027 · 被引用次数：11 · 研究领域：Chronic Disease Management Strategies、Mental Health Research Topics、Diabetes Management and Education

BACKGROUND: Chronic diseases are a leading cause of global morbidity and mortality. In response to this challenge, self-management interventions (SMIs) have emerged as an essential tool in improving patient outcomes. However, the diverse and complex nature of SMIs pose significant challenges in measuring their effectiveness. This work aims to investigate the comparative effectiveness of SMIs on Type 2 diabetes mellitus (T2DM) outcomes. METHODS: A rigorous analytical framework was employed to assess the relative effectiveness of different SMIs, encompassing both pairwise and network meta-analysis (NMA), as well as component network meta-analysis (CNMA). Various outcomes were considered, including glycated hemoglobin (HbA1c) control, body mass index (BMI) reduction and low-density lipoprotein (LDL) cholesterol. Visualization tools were also utilized to enhance the interpretation of results. RESULTS: SMIs were found promising in improving clinical outcomes and patient-reported measures. However, considerable heterogeneity and inconsistency across studies challenged the validity of NMA results. CNMA along with various visualization tools offered insights into the contributions of individual SMI components, highlighting the complexity of these interventions. DISCUSSION/CONCLUSIONS: SMIs represent a valuable approach to managing chronic conditions, but their effectiveness is context-dependent. Further research is needed to elucidate the contextual factors influencing SMI outcomes. ...