PMID- 27819957
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220309
IS  - 1838-2142 (Print)
IS  - 1838-2142 (Linking)
VI  - 8
IP  - 7
DP  - 2010
TI  - Self-monitoring of blood glucose in type 2 diabetes mellitus: systematic review 
      of economic evidence.
PG  - 302-342
AB  - BACKGROUND: Self-monitoring of Blood Glucose (SMBG) is purported to improve 
      glycaemic control, measured by glycosylated haemoglobin (HbA1c). The 
      effectiveness of SMBG in type 2 diabetes mellitus (T2DM) is well-documented 
      though no systematic review of the economic evidence surrounding the use of SMBG 
      in T2DM has been performed. OBJECTIVES: To perform a systematic review of 
      economic evaluations of SMBG in T2DM patients. INCLUSION CRITERIA: All adult 
      patients suffering from T2DM were included. Outcomes of differing treatment 
      groups, where specified, were also recorded. Studies which examined SMBG as an 
      intervention to control blood glucose were considered. To be included, studies 
      must have made a formal attempt to relate cost to outcome data in a 
      cost-effectiveness or cost utility analysis.The main outcomes were in terms of 
      cost-effectiveness and cost-utility. SEARCH STRATEGY: Extensive electronic 
      searches were conducted. Searching was carried out, for the time period 1990 to 
      January 2009, for full text papers and conference abstracts. METHODOLOGICAL 
      QUALITY: Methodological quality of included studies was assessed by two reviewers 
      using the standard critical appraisal tools from the JBI-Actuari (Joanna Briggs 
      Institute-Analysis of Cost, Technology and Utilisation Assessment and Review 
      Instrument). Included modelling studies were also assessed using the review 
      criteria of economic models set out by Phillips and colleagues. DATA COLLECTION: 
      Data from included studies were extracted using the JBI-Actuari extraction tool. 
      DATA SYNTHESIS: Studies were grouped by outcome measure and summarised using 
      tabular and narrative formats. RESULTS: Five studies met the review criteria. 
      Three were model-based analyses assessing long-term cost-effectiveness of SMBG, 
      all of which concluded that SMBG was cost-effective. Two further primary economic 
      evaluations assessed short-term cost-effectiveness. Their results found SMBG to 
      be associated with increased cost and no significant reduction in HbA1c. The 
      studies examined subgroups in terms of their treatment protocols and SMBG was 
      considered more likely to be cost-effective in drug and insulin treated groups 
      compared to diet and exercise groups. CONCLUSIONS: Economic evidence surrounding 
      SMBG in T2DM remains unclear. For the most part, included studies found SMBG to 
      be cost-effective though analyses are extremely sensitive to relative effects, 
      time-frame of analyses and model assumptions. Whilst large uncertainty exists, 
      SMBG may be cost-effective in certain subgroups e.g. drug and insulin-treated 
      patients. IMPLICATION FOR PRACTICE: No strong evidence to recommend the regular 
      use of SMBG in well-controlled diabetes patients, treated only with diet and 
      exercise programmes, exists. The evidence does offer support for SMBG in drug and 
      insulin treated T2DM. It is recommended that clinicians select appropriate 
      patients for SMBG, from these groups, based on their domain expertise. 
      IMPLICATIONS FOR RESEARCH: Large-scale prospective RCTs of SMBG, particularly in 
      drug and insulin treated patients, with well-conducted economic evaluations 
      performed alongside them, will enable a more accurate estimation of the 
      cost-effectiveness of SMBG. The optimal frequency and administration of SMBG is 
      still unknown and is another area that warrants further research.
FAU - de Verteuil, Robyn
AU  - de Verteuil R
AD  - 1. Research Analyst (Health economics), Health Services & Outcomes Research 
      National Healthcare Group, 6 Commonwealth Lane #04 01/02 GMTI Building, Singapore 
      149547. Contact: DID: (65) 6496 6498, Fax: (65) 6496 6256/6257 Email: 
      robyn_de_verteuil@nhg.com.sg 2. Senior Research Analyst (Health economics), 
      Health Services & Outcomes Research National Healthcare Group, 6 Commonwealth 
      Lane #04 01/02 GMTI Building, Singapore 149547. Contact: DID: (65) 6496 6945, 
      Fax: (65) 6496 6256/6257, Email: woan_shin_tan@nhg.com.sg 3. National Healthcare 
      Group HSOR Collaborating Centre for Evidence Based health Services management: A 
      Collaborating Centre of The Joanna Briggs Institute.
FAU - Tan, Woan Shin
AU  - Tan WS
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - JBI Libr Syst Rev
JT  - JBI library of systematic reviews
JID - 101688957
EDAT- 2010/01/01 00:00
MHDA- 2010/01/01 00:01
CRDT- 2016/11/08 06:00
PHST- 2016/11/08 06:00 [entrez]
PHST- 2010/01/01 00:00 [pubmed]
PHST- 2010/01/01 00:01 [medline]
AID - 01938924-201008070-00001 [pii]
AID - 10.11124/01938924-201008070-00001 [doi]
PST - ppublish
SO  - JBI Libr Syst Rev. 2010;8(7):302-342. doi: 10.11124/01938924-201008070-00001.