A systematic review and meta-analysis: Effectiveness of internet empowerment-based self-management interventions on adults with metabolic diseases

Chia-Chi Kuo; Yu-Jen Su; Chiu-Chu Lin

doi:10.1111/jan.13574

A systematic review and meta-analysis: Effectiveness of internet empowerment-based self-management interventions on adults with metabolic diseases

J Adv Nurs. 2018 Mar 25. doi: 10.1111/jan.13574. Online ahead of print.

Authors

Chia-Chi Kuo^{1

2

3}, Yu-Jen Su⁴, Chiu-Chu Lin^{2

5

6}

Affiliations

¹ Emergency Department, Chi-Mei Medical Center, Tainan, Taiwan.
² School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Nursing, Chang Jung Christian University, Tainan, Taiwan.
⁴ Nursing Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

PMID: 29574977
DOI: 10.1111/jan.13574

Abstract

Aim: To synthesize the effects of Internet empowerment-based self-management interventions on adults with metabolic diseases.

Background: Metabolic diseases are prevalent and burden healthcare systems; they have become a major health problem worldwide. The effects of IESMIs on lifestyle changes have been shown to improve adults' physiological and psychological conditions. However, we found no systematic review evaluating these effects.

Design: Systematic review and meta-analysis of randomized and non-randomized controlled trials, conducted according to the Cochrane handbook.

Data resources: A literature search was conducted using the Airiti Library, Association for Computing Machinery, CINAHL, Cochrane Library, Embase, ProQuest, PubMed/MEDLINE and Index of the Taiwan Periodical Literature System databases (earliest-June 2016).

Review methods: Two reviewers used the Cochrane Collaboration bias assessment tool to assess the methodological quality of included studies. Extracted data were entered and analysed using RevMan 5.3.5 software. Inverse variance was used to estimate effect sizes. Weighted and standardized mean differences with 95% confidence intervals were calculated using a random effects model. Subgroup and sensitivity analyses were performed.

Results: Twenty-one randomized controlled trials were reviewed. Meta-analysis showed that the intervention significantly improved adults' exercise habits, glycated haemoglobin (HbA1c) levels, body weight, empowerment levels and quality of life.

Conclusion: The intervention significantly improve the health status of adults with metabolic diseases, in particular their exercise habits, HbA1c levels, body weight, empowerment and quality of life. The intervention provides more convenient and faster access to healthcare for busy individuals with time constraints. These results suggest that healthcare professionals could develop accessible and friendly interactive online interfaces for patients to expand the use of these interventions in the clinical setting.

Keywords: adult; diabetes; empowerment; internet; lifestyle; meta-analysis; metabolic disease; nursing; self-management; systematic review.

Publication types

Review