PMID- 31944439
OWN - NLM
STAT- MEDLINE
DCOM- 20200722
LR  - 20200722
IS  - 1365-2702 (Electronic)
IS  - 0962-1067 (Linking)
VI  - 29
IP  - 9-10
DP  - 2020 May
TI  - Impact of self-care programmes in type 2 diabetes mellitus population in primary 
      health care: Systematic review and meta-analysis.
PG  - 1457-1476
LID - 10.1111/jocn.15186 [doi]
AB  - AIMS AND OBJECTIVES: To evaluate the effectiveness of self-care programmes in 
      type 2 diabetes mellitus (T2DM) population in primary health care. BACKGROUND: 
      The impact of educational interventions on T2DM has been evaluated in various 
      contexts, but there is uncertainty about their impact in that of primary care. 
      DESIGN: Systematic review and meta-analysis. METHODS: A search was conducted in 
      PubMed, CINAHL, WOS and Cochrane databases for randomised controlled trials 
      carried out in the period January 2005-December 2017, including studies with at 
      least one face-to-face educational interventions. The quality of the evidence for 
      the primary outcome was evaluated using the GRADE System. A meta-analysis was 
      used to determine the effect achieved although only the results classified as 
      critical or important were taken into consideration. Checklist of Preferred 
      Reporting Items for Systematic Reviews and Meta-analyses has been followed. 
      PROSPERO registration Number: CRD42016038833. RESULTS: In total, 21 papers (20 
      studies) were analysed, representing a population of 12,018 persons with T2DM. 
      For the primary outcome, HbA(1) c, the overall reduction obtained was -0.29%, 
      decreasing the effect in long-term follow-up. The quality of the evidence was 
      low/very low due to very serious risk of bias, inconsistency and indirectness of 
      results. Better results were obtained for individual randomised trials versus 
      cluster designs and in those programmes in which nurses leaded the interventions. 
      The findings for other cardiovascular risk factors were inconsistent. 
      CONCLUSIONS: Educational interventions in primary care addressing T2DM could be 
      effective for metabolic control, but the low quality of the evidence and the lack 
      of measurement of critical results generates uncertainty and highlights the need 
      for high-quality trials. RELEVANCE TO CLINICAL PRACTICE: Most of self-care 
      programmes for T2DM in primary care are focused on metabolic control, while other 
      cardiovascular profile variables with greater impact on mortality or 
      patient-reported outcomes are less intensely addressed.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Caro-Bautista, Jorge
AU  - Caro-Bautista J
AUID- ORCID: 0000-0001-9357-9549
AD  - Servicio Andaluz de Salud, Distrito Sanitario Malaga-Valle del Guadalhorce, 
      Malaga, Spain.
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
FAU - Kaknani-Uttumchandani, Shakira
AU  - Kaknani-Uttumchandani S
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
AD  - Facultad de Ciencias de la Salud, Universidad de Malaga, Malaga, Spain.
FAU - Garcia-Mayor, Silvia
AU  - Garcia-Mayor S
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
AD  - Facultad de Ciencias de la Salud, Universidad de Malaga, Malaga, Spain.
FAU - Villa-Estrada, Francisca
AU  - Villa-Estrada F
AD  - Servicio Andaluz de Salud, Distrito Sanitario Malaga-Valle del Guadalhorce, 
      Malaga, Spain.
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
FAU - Morilla-Herrera, Juan Carlos
AU  - Morilla-Herrera JC
AUID- ORCID: 0000-0003-3814-4440
AD  - Servicio Andaluz de Salud, Distrito Sanitario Malaga-Valle del Guadalhorce, 
      Malaga, Spain.
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
AD  - Facultad de Ciencias de la Salud, Universidad de Malaga, Malaga, Spain.
FAU - Leon-Campos, Alvaro
AU  - Leon-Campos A
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
AD  - Hospital Regional Universitario de Malaga, Malaga, Spain.
FAU - Gomez-Gonzalez, Alberto Jose
AU  - Gomez-Gonzalez AJ
AUID- ORCID: 0000-0002-9560-7213
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
FAU - Morales-Asencio, Jose Miguel
AU  - Morales-Asencio JM
AUID- ORCID: 0000-0001-7911-7487
AD  - Instituto de Investigacion Biomedica de Malaga-IBIMA, Malaga, Spain.
AD  - Facultad de Ciencias de la Salud, Universidad de Malaga, Malaga, Spain.
LA  - eng
GR  - PI-0005-2015/Andalusian Health Ministry/
GR  - 2014-DGSM-COD4/District of Primary Healthcare of Malaga-Valle del Guadalhorce/
GR  - PI14/01127/Instituto de Salud Carlos III/
GR  - European Regional Development Fund/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200130
PL  - England
TA  - J Clin Nurs
JT  - Journal of clinical nursing
JID - 9207302
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Primary Health Care/organization & administration
MH  - Program Evaluation
MH  - Randomized Controlled Trials as Topic
MH  - Research Design/standards
MH  - Self Care/*standards
OTO - NOTNLM
OT  - Type 2 Diabetes Mellitus
OT  - diabetes education
OT  - meta-analysis
OT  - primary health care
OT  - self-care
EDAT- 2020/01/17 06:00
MHDA- 2020/07/23 06:00
CRDT- 2020/01/17 06:00
PHST- 2019/09/05 00:00 [received]
PHST- 2019/12/06 00:00 [revised]
PHST- 2020/01/10 00:00 [accepted]
PHST- 2020/01/17 06:00 [pubmed]
PHST- 2020/07/23 06:00 [medline]
PHST- 2020/01/17 06:00 [entrez]
AID - 10.1111/jocn.15186 [doi]
PST - ppublish
SO  - J Clin Nurs. 2020 May;29(9-10):1457-1476. doi: 10.1111/jocn.15186. Epub 2020 Jan 
      30.