TY -的盟Eberle克劳迪娅AU - Stichling,斯蒂芬妮PY - 2021 DA - 2021/2/19 TI -临床改善通过远程医疗干预管理1型和2型糖尿病:系统方法乔- J地中海互联网Res SP - e23244六世- 23 - 2 KW - 1型糖尿病KW - 2型糖尿病KW -电子健康KW -远程医疗KW -疾病管理KW -系统回顾KW -手机AB -背景:糖尿病(DM)是世界上最大的健康威胁之一,患病率上升。全球数字化为糖尿病管理带来了新的数字化方法，例如远程医疗干预。远程医疗是信息和通信技术的使用，可以跨越空间距离提供医疗服务，通过增加获得糖尿病护理和医疗信息的机会来改善临床患者的结果。目的:本研究旨在通过合并1型糖尿病(T1DM)和2型糖尿病(T2DM)患者的研究，检验远程医疗干预是否有效改善糖尿病控制，以及诊断为T2DM的患者是否比诊断为T1DM的患者受益更大。我们分析了主要终点糖化血红蛋白A1c (HbA1c)和次要终点空腹血糖(FBG)、血压(BP)、体重、BMI、生活质量(QoL)、成本和节省的时间。方法:通过检索Cochrane Library、MEDLINE via PubMed、Web of Science Core Collection、Embase和CINAHL数据库，系统识别2008年1月至2020年4月期间发表的研究，考虑系统评价(SRs)、荟萃分析(MAs)、随机对照试验(rct)和临床试验(CTs)。使用评估系统评价的测量工具、有效的公共卫生实践项目和国家健康与护理卓越研究所定性检查表评估研究质量。我们通过实时视频或音频干预、异步干预和联合干预(同步和异步通信)中的通信技术组织了试验。结果:从1116篇唯一引用中，我们确定了31篇合格的研究(n=15篇高质量，n=14篇中等质量，n=1篇弱质量，n=1篇极低质量)。我们选择了21项sr和ma, 8项rct, 1项非rct和1项定性研究。 Of the 10 trials, 3 were categorized as real-time video, 1 as real-time video and audio, 4 as asynchronous, and 2 as combined intervention. Significant decline in HbA1c levels based on pooled T1DM and T2DM patients data ranged from −0.22% weighted mean difference (WMD; 95% CI −0.28 to −0.15; P<.001) to −0.64% mean difference (95% CI −1.01 to −0.26; P<.001). The intervention effect on lowering HbA1c values might be significantly smaller for patients with T1DM than for patients with T2DM. Evidence on the impact on BP, body weight, FBG, cost effectiveness, and time saving was smaller compared with HbA1c but indicated potential in some publications. Conclusions: Telemedical interventions might be clinically effective in improving diabetes control overall, and they might significantly improve HbA1c concentrations. Patients with T2DM could benefit more than patients with T1DM regarding lowering HbA1c levels. Further studies with longer duration and larger cohorts are necessary. SN - 1438-8871 UR - //www.mybigtv.com/2021/2/e23244/ UR - https://doi.org/10.2196/23244 UR - http://www.ncbi.nlm.nih.gov/pubmed/33605889 DO - 10.2196/23244 ID - info:doi/10.2196/23244 ER -