Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis
Hassan Hosseinzadeh A B , Iksheta Verma A and Vinod Gopaldasani A
+ Author Affiliations
- Author Affiliations
A School of Health and Society, Building 15, Room 146, University of Wollongong, NSW 2522, Australia.
B Corresponding author. Email: hassanh@uow.edu.au
Australian Journal of Primary Health 26(6) 431-442 https://doi.org/10.1071/PY19204
Submitted: 22 October 2019 Accepted: 23 September 2020 Published: 23 November 2020
Abstract
Patient activation has been recognised as a reliable driver of self-management decision-making. This systematic review and meta-analysis examines existing evidence on whether embedding patient activation within Type 2 diabetes mellitus (T2DM) self-management programs can improve patient outcomes. This review has included 10 randomised controlled trials (RCTs) conducted between 2004 and 2019 retrieved from well-known databases such as MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest and ScienceDirect. The eligible RCTs were excluded if they scored low according to Cochrane Collaboration’s ‘risk of bias’ criteria. Random-effects meta-analyses showed that there were no significance changes in haemoglobin A1C (HbA1c), body mass index (BMI) and patient activation measure (PAM) between intervention and control groups after the intervention; however, the systematic review findings indicated that an improved patient activation level led to significant improvements in T2DM self-management and clinical outcomes including HbA1c level. Studies with a longer follow-up period conducted in community settings and delivered by peer coaches were more likely to lead to significant improvement in both patient activation levels and T2DM self-management and clinical outcomes. This review concludes that patient activation can be used as a reliable tool for improving T2DM self-management and clinical outcomes.
Keywords: diabetes self-management, meta-analysis, patient activation, systematic review.
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