Elizabeth M. Heitkemper|Lena Mamykina|Jasmine Travers|Arlene Smaldone
Do health information technology self-management interventions improve glycemic control in medically underserved adults with diabetes? A systematic review and meta-analysis
Columbia University Irving Medical Center|Columbia University Irving Medical Center|University of Pennsylvania|Columbia University Irving Medical Center
purpose systematic review metaanalysis examine effect health information technology hit diabetes selfmanagement education dsme interventions glycemic control medically underserved patientsfollowing priori protocol 5 databases searched studies appraised quality using cochrane risk bias assessment studies reporting either hemoglobin a1c pre postintervention change 6 12 months eligible inclusion metaanalysis using random effects modelsthirteen studies met criteria systematic review 10 metaanalysis represent data 3257 adults diabetes mean age 55 years 66 female 74 racialethnic minorities studies n 10 reflected unclear risk bias interventions varied hit type computer software without internet n 2 cellularautomated telephone n 4 internetbased n 4 telemedicinetelehealth n 3 pooled a1c decreases found 6 months 036 95 ci 053 019 2 351 q 50 diminishing effect 12 months 027 95 ci 049 004 2 424 q 104findings suggest medically underserved patients diabetes achieve glycemic benefit following hit dsme interventions dissipating significant effects 12 months telemedicinetelehealth interventions successful hit type incorporated interaction educators similar inperson dsmethese results similar inperson dsme medically underserved patients showing welldesigned hit dsme potential increase access improve outcomes vulnerable group