Assessment of remote patient monitoring (RPM) systems for patients with type 2 diabetes: a systematic review and meta-analysis

Abstract

Introduction: The objective of this study is to conduct an assessment of Remote Patient Monitoring (RPM) systems compared to usual care for controlling glycosylated hemoglobin in type 2 diabetes.

Methods: The study was a systematic review with meta-analysis and meta-regression. A systematic search was performed via the most important electronic databases of medical resources, such as PubMed, Scopus and Cochrane library. The main outcome was HbA1C. The heterogeneity sources were examined using Chi-square (Q) and I2 tests. Meta-analyses were done using Stata version 11 software. Statistical significance was defined as P < 0.05. Random effects model was used in meta-analysis, and the heterogeneity more than 50% was considered as significant.

Results: The results of the systematic review and meta-analysis indicated that the effect size index (Difference of Pre-test/Post-test Control Design-2nd method "using pooled pretest SD" (DPPC2)) among users of RPM for type 2 diabetic patients was -0.32 with a confidence interval of 95% (from -0.45 to -0.19) as compared to the control group. The current study declared a vital role of RPM technology in reduction of hemoglobin glycogen levels. The results of the subgroup analysis showed that RPM is more effective for patients who are residents of cities, having intervention lengths less than 6 months, getting the orders from the physician and using the websites as their intervention type.

Conclusion: The current study indicted the efficacy of RPM in reducing HbA1c among type 2 diabetic patients, which could be a base for policymakers to decide on the introduction of this technology in Iran.

Keywords: Glycosylated hemoglobin; Meta-analysis; Remote monitoring; Systematic review; Type 2 diabetes.

© Springer Nature Switzerland AG 2020.

Figures

Fig. 1

Screening flowchart of the studies according to PRISMA standard

Fig. 2

The risk of bias using Cochrane criteria

Fig. 3

Summary of the bias characteristics

Fig. 4

Estimation of meta-analysis to determine the overall effectiveness of RPM technology

Fig. 5

Determining the effect of lost to follow-up on the effectiveness of RPM technology

Fig. 6

Funnel diagram for the study of publication bias

Fig. 7

Sensitivity analysis