Home telehealth for diabetes management: a systematic review and meta-analysis.
OBJECTIVE
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.
Polisena
J
J
Canadian Agency for Drugs and Technologies in Health, 600-865 Carling Avenue, Ottawa, Ontario K1S 5S8, Canada. juliep@cadth.ca
Tran
K
K
Cimon
K
K
Hutton
B
B
McGill
S
S
Palmer
K
K
D003920:Diabetes Mellitus / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D017216:Telemedicine / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data