Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 4, 2023
Date Accepted: Jul 31, 2023
Role of Caregivers in Remote Management of Type 2 Diabetes Mellitus patients – A systematic review of literature
ABSTRACT
Background:
With growing use of remote monitoring technologies in the management of Type 2 diabetes mellitus (T2DM) patients, caregivers are becoming important resources that can be tapped on to improve patient care.
Objective:
This review aims to summarize the role of caregivers in the remote monitoring of T2DM patients.
Methods:
A systematic review was performed in Medline®, Embase®, Scopus®, Psychinfo® and Web of Science® up till 2022. Studies which evaluated the role of caregivers in remote management of adult T2DM patients were included. Outcomes such as diabetes control, adherence to medication, quality of life, frequency of home glucose monitoring and healthcare utilization were evaluated.
Results:
Results Of 1198 citations identified, 11 articles were included. Majority of studies were conducted in North (n=7, 63.6%) and South America (n=2, 18.2%) respectively. The main types of caregivers studied included family or friends (n=10, 90.9%) while the most common remote monitoring modalities evaluated were interactive voice response (n=5, 45%) and phone consultations (n=4, 36.4%). With regards to diabetes control, 3 out of 6 studies showed improvement in diabetes related laboratory parameters. Two studies showed improvement in patients’ medication adherence rates and frequency of home glucose monitoring. Studies which evaluated patients’ quality of life showed mixed evidence on patients’ quality of life. Increased hospitalisation rates were noted in the intervention group in 1 study. Discussion The positive impacts of caregivers on remote monitoring of T2DM patients likely arise from their assistance in bridging technological gaps encountered by patients. With regards to diabetes control, the mixed effects stems from methodological related issues such as short follow-up. Healthcare administrators should also be cognizant about increased caregiver stress and burden with remote monitoring which can culminate in negative health related outcomes.
Conclusions:
Caregivers may play a role in improving clinical outcomes among T2DM patients under remote monitoring. Studies on mHealth are lacking to understand their impact in Asian populations and long-term patient outcomes. Clinical Trial: Not applicable
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