Telephone-call support to improve glycaemic control in type two diabetes mellitus

Abstract

Topic Overview: Diabetes Mellitus is a chronic condition that entails lifestyle modifications to prevent micro and macrovascular complications. Individuals with diabetes require on-going support to self-manage their condition and reach glycaemic control. This literature review addressed the effectiveness of providing support through telephone-call interventions. Research Question: “In individuals with Type 2 Diabetes Mellitus, do phone-based interventions improve glycaemic control?” PICO Elements: The population studied comprised of adults with T2DM. The intervention under review was using phone call support from clinicians to patients. The comparison intervention was usual care. The expected outcome was improved glycaemic control. Methods: Several search terms were used and combined with search tools and limiters to form a systematic and comprehensive search strategy. EBSCO, PubMed and Scopus were used for the search. The PRISMA framework was selected to guide the screening process of articles. Eligibility criteria were employed to further guide the selection of key studies. RCT studies that were selected as key studies were required to be written in English and published after 2000. The CASP tool was used to appraise studies and assess any risk for bias. Results: The key studies compromised of six RCT studies. The results were inconsistent, however significantly greater reductions in HbA1x were observed amongst the intervention groups in most of the studies. Many methodological differences and limitations were observed, which could justify the inconsistencies. The PICO question for this study was not conclusively answered, although this systematic review found evidence supporting the intervention. Implications and recommendations: Recommendations for future research include further studies that look into this intervention by using extended follow-up periods and larger sample sizes. For the local setting, staff training on the use of telephone interventions is required for health care workers together with creating awareness on the added advantages that come out from the implementation of the intervention for nursing practice. Furthermore, financial resources are necessary to implement telephone-call interventions.