Telehealth impact on biomedical, psychosocial, and behavioural outcomes in patients with diabetes older than 50 years: A systematic synthesis without meta-analysis
Abstract
Background: Elderly people with diabetes are among high-risk groups that require more attention. With the increasing use of technology in healthcare, much emphasis has been placed on telehealth because of its potential to reduce unnecessary healthcare services consumption. We aimed to review and analyse the evidence of various interventions on the effect of using telehealth on biomedical, behavioural, and psychosocial outcomes in patients with diabetes over 50 years. Methods: The search method of this systematic synthesis without meta-analysis was guided by the preferred reporting items for systematic reviews (PRISMA) and the new reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. A coherent search strategy was designed to retrieve articles in databases such as PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to June 2020. We excluded articles with eligibility criteria of the age of under 50 years old and studies conducted on patients with gestational diabetes. The outcomes were categorized into biomedical, behavioural, and psychosocial outcomes. The methodology of articles was evaluated by the Standard Cochrane Collaboration risk of bias tool in Revman 5.3 software. Findings: Overall, 18 studies with 8273 patients with diabetes over the age of 50 were included in this systematic review. Biomedical outcomes such as blood sugar tests and cholesterol tests had significant improvement by using telehealth. Frequency of self-monitored blood glucose (SMBG) and self-efficacy were behavioural outcomes that increased by telehealth utilization. Telehealth had a positive impact on psychosocial outcomes like depression, quality of life (QoL), cognitive decline, and social support. Interpretation: Telehealth has the ability to improve multiple outcomes such as behavioural and psychosocial outcomes in health services consumers. Due to varied telehealth interventions and follow-up durations, firm conclusions cannot be reached. As the research investigations studied in the present study were of different kinds and had used different follow-up periods, there is a need for further rigorous studies which consider socio-economic, cultural, and clinical differences.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Virtual care interventions had a greater effect among adults aged 50 years or older, with better treatment outcomes compared to younger adults, as reported in five reviews.
“Virtual care interventions were found to have greater effect among adults who were 50 years or older, with better treatment outcomes compared to younger adults reported in 5 reviews [21, 22, 26, 29, 36].”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [22]
All seven reviews reported a reduction in blood pressure with virtual care.
“all 7 reviews [22, 27, 32, 35, 37, 44, 46] reported reduction in blood pressure.”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [22]
Cites
PRISMA-P Group, Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015) · Systematic Reviews · doi:10.1186/2046-4053-4-1 · Cited by 26,223 · see citing works
Telehealth and patient satisfaction: a systematic review and narrative analysis
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016242 · Cited by 1,350 · see citing works
Shuster, J. J. (2011) · Research Synthesis Methods · doi:10.1002/jrsm.38 · Cited by 297 · see citing works
DialBetics: A Novel Smartphone-based Self-management Support System for Type 2 Diabetes Patients
Waki, K., Fujita, H., Uchimura, Y., Omae, K., Aramaki, E., Kato, S., Lee, H., Kobayashi, H., Kadowaki, T., & Ohe, K. (2014) · Journal of Diabetes Science and Technology · doi:10.1177/1932296814526495 · Cited by 203 · see citing works
Lee, P. A., Greenfield, G., & Pappas, Y. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3274-8 · Cited by 162 · see citing works
Beishuizen, C. R., Stephan, B. C., van Gool, W. A., Brayne, C., Peters, R. J., Andrieu, S., Kivipelto, M., Soininen, H., Busschers, W. B., Moll van Charante, E. P., et al. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5218 · Cited by 128 · see citing works
Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies
Schnell, O., Alawi, H., Battelino, T., Ceriello, A., Diem, P., Felton, A.-M., Grzeszczak, W., Harno, K., Kempler, P., Satman, I., et al. (2013) · Journal of Diabetes Science and Technology · doi:10.1177/193229681300700225 · Cited by 88 · see citing works
Telemedicine consultation for patients with diabetes mellitus: A cluster randomised controlled trial
Sood, A., Watts, S. A., Johnson, J. K., Hirth, S., & Aron, D. C. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17704346 · Cited by 86 · see citing works
Huang, Z., Tao, H., Meng, Q., & Jing, L. (2015) · European Journal of Endocrinology · doi:10.1530/eje-14-0441 · Cited by 81 · see citing works
Weinstock, R. S., Brooks, G., Palmas, W., Morin, P. C., Teresi, J. A., Eimicke, J. P., Silver, S., Izquierdo, R., Goland, R., & Shea, S. (2011) · Age and Ageing · doi:10.1093/ageing/afq147 · Cited by 72 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Robinson, D. J., Hanson, K., Jain, A. B., Kichler, J. C., Mehta, G., Melamed, O. C., Vallis, M., Bajaj, H. S., Barnes, T., Gilbert, J., et al. (2023) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2023.04.009 · Cited by 73 · see citing works
Ravi, S., Meyerowitz-Katz, G., Yung, C., Ayre, J., McCaffery, K., Maberly, G., & Bonner, C. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12496-0 · Cited by 19 · see citing works
“Virtual care interventions were found to have greater effect among adults who were 50 years or older, with better treatment outcomes compared to younger adults reported in 5 reviews [21, 22, 26, 29, 36].”
InfluentialTan, N., Tyagi, S., Lee, C. S., Koh, E., Goh, K. L. S., Gong, P. P., Ang, S. B., & Koh, C. H. G. (2023) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x231203490 · Cited by 13 · see citing works
Zheng, Z., Li, C., Xie, R.-H., Xie, H.-L., Fu, F., Pan, Y.-H., Liao, J., Chen, X., & Yue, L.-Q. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.05.084 · Cited by 13 · see citing works
Chinese Expert Consensus on Home Nutrition Administration for Older Patients (2024)
Gong, J., Li, X., Shi, L., Jing, X., Liao, X., Ma, Y., & Hu, W. (2025) · Journal of Evidence-Based Medicine · doi:10.1111/jebm.70025 · Cited by 3 · see citing works
Twenty-first century management of diabetes with shared telemedicine appointments
Klonoff, D. C., Yeung, A. M., Huang, J. K., Espinoza, J., Raymond, J. K., Lee, W.-A., Koliwad, S. K., & Kerr, D. E. (2023) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x231184503 · Cited by 7 · see citing works
“13,14 However, the number of severe hypoglycemic events and diabetes knowledge was not statistically different between the comparator groups.”
Effective Interventions for Homebound Older Adults With Type 2 Diabetes: A Systematic Review
Iregbu, S., Dawson, A. Z., Walker, R., & Egede, L. E. (2025) · Current Diabetes Reports · doi:10.1007/s11892-025-01584-4 · Cited by 1 · see citing works
“Integrating home telehealth with the hospital’s electronic health records allows providers to intervene promptly and tailor interventions to patients’ health needs [45] and is worthy of further exploration in this population.”
Lee, W.-R., Lee, G.-M., Son, N., Han, K.-T., Chun, S., Son, Y., & Yoo, K. (2024) · Preventive medicine reports · doi:10.1016/j.pmedr.2024.102946 · Cited by 1
“Older patients with diabetes, in particular, belong to a high-risk group that requires extra attention (Mohammad et al., 2021).”
A Comparative Study of Consumer Decision-Making and Patient Health Behaviour in Digital Ecosystems
Pal, A., & Hariharan, H. (2026) · International Journal of Drug Delivery Technology · doi:10.25258/ijddt.16.65s.44
Wiesmüller, F., Kreiner, K., Reinisch, V., Hoffmann, F., Schreier, G., & Hayn, D. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1720149
“Therefore, the American Diabetes Association recommends the usage of telehealth to provide enhanced timely access to diabetes care, educational content, self-management services and for an optimized glycemic management (10–13).”
- Authors
- Kaveh, M. H., Faradonbeh, M. R., & Kaveh, S.
- Affiliations
- Shiraz University (IR)
- Shiraz University of Medical Sciences (IR)
- Corresponding author
- Kaveh, Sara
- ORCID
- Kaveh, Sara
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2021-11-18
- Volume
- 30
- Issue
- 2
- Pages
- 285-304
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W3213449614
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 6 · 2022: 1
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (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
- Social Sciences › Demography › Technology Use by Older Adults
- Keywords
- telemedicine, diabetes mellitus, older adults, self-monitoring of blood glucose, self-efficacy, depression, quality of life, cognitive decline, social support, glycemic control, cholesterol, behavioural outcomes, psychosocial outcomes
- MeSH terms
- Aged, Delivery of Health Care, Diabetes Mellitus, Health Services, Humans, Middle Aged, Quality of Life, Telemedicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
