Effectiveness of digital health interventions for diabetes: Systematic review of systematic reviews
Abstract

Introduction: The use of digital health technologies to tackle diabetes has been particularly flourishing in recent years. Previous studies have shown to varying degrees that these technologies can have an impact on diabetes prevention and management. The objective of this review is to summarize the best evidence regarding the effectiveness of digital health interventions to improve one or more diabetes indicators. Methods: We included all types of interventions aimed at evaluating the effect of digital health on diabetes. We considered at all types of digital interventions (mobile health, teleconsultations, tele expertise, electronic health records, decision support systems, e-learning, etc.). We included systematic reviews published in English or French over the last 29 years, from January 1991 to December 2019 that met the inclusion criteria. Two reviewers independently reviewed the titles and abstracts of the studies to assess their eligibility, and extracted relevant information according to a predetermined grid. Any disagreement was resolved by discussion and consensus between the two reviewers, or involved a third author as referee. Results: We included 10 reviews in total. The outcomes of interest were clinical indicators of diabetes that could be influenced by digital interventions. These outcomes had to be objectively measurable indicators related to diabetes surveillance and management that are generally accepted by diabetes experts. Six of the ten reviews showed moderate to large significant reductions in glycated haemoglobin (HBA1c) levels compared to controls. Most reviews reported overall positive results and found that digital health interventions improved health care utilization, behaviours, attitudes, knowledge and skills. Conclusion: Based on a large corpus of scientific evidence on digital health interventions, this over view could help identify the most effective interventions to improve diabetes indicators.

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