title: Are home visits an effective method for diabetes management? A quantitative systematic review and meta-analysis.
abstract: OBJECTIVE
  Previous reviews have revealed uncertainty regarding the effectiveness of home visit interventions for managing diabetes. Therefore, we carried out a quantitative systematic review and meta-analysis to evaluate the effects of home visit interventions among patients with diabetes.
  
  
  METHODS
  We searched various electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, Wanfang and Chinese scientific full-text databases) from their inception until March 2016. We included randomized controlled trials that included patients with diabetes, and evaluated the effects of home visit programs on glycated hemoglobin concentrations. Two reviewers independently used the Cochrane Collaboration methods to assess the included studies' risk of bias and quality.
  
  
  RESULTS
  We included seven randomized controlled trials with 686 participants. Compared with the usual care, the home visit group showed a greater reduction in glycated hemoglobin concentrations (mean difference -0.79% [-9 mmol/mol], 95% confidence interval [CI]: -0.93 to -0.25% [11 to -3 mmol/mol]; P < 0.05; I2= 0%), systolic blood pressure (mean difference -5.94 mmHg, 95% confidence interval -11.34 to -0.54 mmHg) and diastolic blood pressure (mean difference -6.32 mmHg, 95% confidence interval -12.00 to -0.65 mmHg). Furthermore, home visits improved quality of life, high-density lipoprotein, low-density lipoprotein, total triglycerides and self-management. However, there were no significant differences between the two groups in their bodyweight, total cholesterol, body mass index and self-efficacy.
  
  
  CONCLUSIONS
  Home visits were associated with improved glycemic control and reduced cardiovascular risk factors, which shows that it is an effective method for diabetes management.
authors.affiliation: Nursing Department, Gansu Provincial Hospital, Lanzhou, Gansu, China.|School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.affiliation: School of Nursing, Lanzhou University, Lanzhou, Gansu, China.|Medical College, Northwest University for Nationalities, Lanzhou, Gansu, China.
authors.forename: Yuxia
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, Gansu, China.
authors.forename: Suhong
authors.initials: S
authors.lastname: Wei
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Cardiology, Gansu Provincial Hospital, Lanzhou, Gansu, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Yang
authors.affiliation: School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Shen
authors.affiliation: School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Nursing Department, Affiliated Hospital of Medical College of Chinese People's Armed Police Force, Tianjin, China.
authors.forename: Yuexian
authors.initials: Y
authors.lastname: Shi
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control; D048909:Diabetes Complications / Q000628:therapy; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006792:House Calls; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin
keywords: Diabetes; Home visit; Meta-analysis