Effects of therapeutic patient education interventions on diabetes self-management outcomes in the Eastern Mediterranean Region: a systematic review
Notice bibliographique
Résumé
BACKGROUND: Therapeutic patient education (TPE) is a structured, person-centered educational process designed to empower individuals living with non-communicable diseases, such as diabetes mellitus. Educational interventions addressing diabetes in the Eastern Mediterranean Region (EMR) are isolated , and their effectiveness is not well reported. Therefore, this systematic review evaluates the impact of TPE interventions on diabetes self-management outcomes in the EMR. METHODS: We searched six databases (MEDLINE OVID, PubMed, Web of Science, Scopus, CINAHL, and ScienceDirect) for relevant articles. Articles were included if they reflected on TPE initiatives addressing diabetes, conducted in the EMR, delivered by healthcare professionals or multidisciplinary healthcare teams, and utilized TPE components and/or constructs. Data extraction included self-management outcomes of diabetes mellitus and the country of intervention. Effect sizes were computed for all outcomes. RESULTS: 24 articles, including TPE constructs (knowledge, skills, and confidence) or components (goal setting, action planning, shared decision-making), were included in the analysis. Most articles were randomized controlled trials (n = 14). Workshops and educational sessions in group settings were the most common modality of TPE interventions (n = 18). Results were reported based on self-management outcomes: [1] self-care [2], anthropometric and lifestyle, and [3] biological outcomes. The combination of knowledge and confidence (n = 8), and goal setting (n = 8) were the most reported combinations of the patient competency profile and TPE components, respectively. Most studies (n = 18) reported on self-care outcomes, such as general or specific diet adherence, blood glucose monitoring, foot care, and medication adherence, with effect sizes ranging from small to large. 16 articles also reported on biological measures (glycemic, lipid profile, and blood pressure measurements), 11 on anthropometric outcomes (body mass index-BMI, weight, and waist circumference), 4 on dietary outcomes, and 4 on physical activity outcomes. Mixed effect sizes were observed for anthropometric and biological outcomes, with most studies revealing small effect sizes for changes in BMI, weight, and blood lipids. In contrast, large and significant effect sizes for waist circumference, HbA1c, and fasting blood glucose were noted. CONCLUSION: Despite varying effect sizes for most outcomes, TPE interventions in the EMR showed significant improvements in several diabetes self-management outcomes, including waist circumference, HbA1c, and fasting blood glucose. TPE components and constructs were more prevalent with significant improvements and considerable effect in self-care and biological outcomes, particularly when the TPE constructs were utilized in combinations of two or more. PROSPERO, registration number CRD42024601438.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,008 | 0,007 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».