Effects of consumer-oriented health information technologies in diabetes management over time: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
To reveal the effects of consumer-oriented health information technologies (CHITs) on patient outcomes in diabetes management over time through systematic review and meta-analysis.


METHODS
We searched 5 electronic databases (from database inception to July 2016) for studies that reported on randomized controlled trials examining the effects of CHITs on glycemic control and other patient outcomes in diabetes management. Data were analyzed using either meta-analysis or a narrative synthesis approach.


RESULTS
Eighty randomized controlled trial studies, representing 87 individual trials, were identified and included for analysis. Overall, the meta-analysis showed that the use of CHITs resulted in significant improvement in glycemic control compared to usual care (standardized mean difference = -0.31%, 95% confidence interval -0.38 to -0.23, P  < .001) in patients with diabetes. Specifically, improvement in glycemic control was significant at intervention durations of 3, 6, 8, 9, 12, 15, 30, and 60 months, while no significant differences were found at other time points reported. The narrative synthesis provided mixed effects of CHITs on other clinical, psychosocial, behavioral, and knowledge outcomes.


CONCLUSIONS
The use of CHITs appears to be more effective than usual care in improving glycemic control for patients with diabetes. However, their effectiveness did not remain consistent over time and in other patient outcomes. Further efforts are required to examine long-term effects of CHITs and to explore factors that can moderate the effects over time.
Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China.
Da
D
Tao
School of Management, Xi'an Polytechnic University, Xi'an, China.
Tieyan
T
Wang
School of Management, Xi'an Polytechnic University, Xi'an, China.
Tieshan
T
Wang
Marine Human Factors Engineering Lab, China Institute of Marine Technology and Economy, Beijing, China.
Shuang
S
Liu
Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China.
Xingda
X
Qu
D054626:Consumer Health Information; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008490:Medical Informatics; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D012648:Self Care
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
diabetes management; health information technologies; meta-analysis