Home telehealth for diabetes management: a systematic review and meta‐analysis
Abstract
Aim: It is estimated that more than 180 million people worldwide have diabetes. Health‐care providers can remotely deliver health services to this patient population using information and communication technology, also known as home telehealth. Home telehealth may be classified into two subtypes: home telemonitoring (HTM) and telephone support (TS). The research objective was to systematically review the literature and perform meta‐analyses to assess the potential benefits of home telehealth compared with usual care (UC) for patients with diabetes. Methods: An electronic literature search was conducted to identify studies on home telehealth and patients with diabetes that were published between 1998 and 2008 using Medline, Medline In‐Process & Other Non‐Indexed Citations, BIOSIS Previews and EMBASE. Results: Twenty‐six studies (n = 5069 patients) on home telehealth for diabetes were selected. Twenty‐one studies evaluated HTM and 5 randomized controlled trials assessed TS. HTM had a positive effect on glycaemic control [as measured by lower glycated haemoglobin level] compared with UC (weighted mean difference =−0.21; 95% confidence interval −0.35 to −0.08), but the results were mixed for TS. Study results indicated that home telehealth helps to reduce the number of patients hospitalized, hospitalizations and bed days of care. Home telehealth was similar or favourable to UC across studies for quality‐of‐life and patient satisfaction outcomes. Conclusions: In general, home telehealth had a positive impact on the use of numerous health services and glycaemic control. More studies of higher methodological quality are required to give more precise insights into the potential clinical effectiveness of home telehealth interventions.
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In Type 2 diabetes, there were small but statistically significant pooled decreases in HbA1c of −0.6% and a weighted mean difference of −0.2% (95% CI −0.4 to −0.1).
“Type 2 diabetes (−0.6% in HbA1c [39]), (weighted mean difference, −0.2%, 95% C.I. −0.4 to −0.1 [41])”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [41]
Another review of diabetes studies reported a reduced number of patients hospitalised with telephone support, but found no studies of home-telemonitoring systems.
“Another review of diabetes studies also reported a reduced number of patients hospitalised with telephone support, but found no studies of home-telemonitoring systems. [41].”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [41]
Another review reported that quality of life was similar in the intervention arm to the usual care arm in diabetes.
“In diabetes, one review found benefits to quality of life, self-efficacy and social advantages [39], whereas another reported that quality of life was similar in the intervention arm to the usual care arm [41].”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [41]
Four of the 2-star mixed diabetes reviews included meta-analyses of impact on HbA1c, with three showing significant improvements over controls.
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
Interventions in the 2-star mixed diabetes meta-analyses included telemonitoring of blood sugar and interactive telehealth excluding telephone support.
“Interventions included telemonitoring of blood sugar [40,44] and interactive telehealth excluding telephone support [27].”
Eight mixed diabetes reviews were weighted 2 stars.
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c.
“Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c [27,30,35-37,40,44-46].”
Monitoring and feedback was associated with improved clinical outcomes in diabetes and heart failure.
“This was the most commonly described telehealth component in the included systematic reviews and was associated with improved clinical outcomes in diabetes and heart failure [33,35,36,38,42,44,54,58]; however, findings for asthma and COPD were mostly neutral or inconsistent [61-63,65,66,68,69].”
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Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes
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Home Telehealth: Patient Satisfaction, Program Functions, and Challenges for the Care Coordinator
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Home telemental health implementation and outcomes using electronic messaging
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- Authors
- Polisena, J., Tran, K., Cimon, K., Hutton, B., McGill, S., & Palmer, K.
- Affiliations
- Canada's Drug Agency (CA)
- Corresponding author
- Polisena, J.
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2009-09-11
- Volume
- 11
- Issue
- 10
- Pages
- 913-930
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2106144638
- Cited by
- 239
- References
- 45
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 14 · 2022: 12 · 2021: 11 · 2020: 14 · 2019: 13 · 2018: 12 · 2017: 12 · 2016: 24 · 2015: 18 · 2014: 25 · 2013: 23 · 2012: 16
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- home telehealth, diabetes management, home health monitoring, telephone support, glycemic control, HbA1c, hospitalization, quality of life, patient satisfaction, remote care, usual care comparison
- MeSH terms
- Diabetes Mellitus, Home Care Services, Humans, Quality of Life, Patient Satisfaction, Outcome Assessment, Health Care, Telemedicine
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