PDF(Pubmed)
Abstract：
As diabetes self-management necessitates life-long learning, behaviour change, support, and monitoring, health coaching is a promising intervention to assist individuals in more than just meeting glycemic goals and glycated hemoglobin (A1C) targets. Currently, studies of health coaching for type 2 diabetes (T2DM) are limited due to their emphasis on glycemic control. The goal of this systematic review and meta-analysis is to determine the effects of health coaching on adults with T2DM based on quadruple aim outcomes and to assess the implementation of these interventions.
We searched 6 databases for randomized controlled trials of health coaching interventions delivered by a health professional for adults with T2DM. Reviewers screened citations, extracted data, and assessed risk of bias and certainty of evidence (GRADE). We assessed statistical and methodological heterogeneity and performed a meta-analysis of studies.
Nine studies were included in this review. Our meta-analysis showed a significant reduction of A1C [0.24 (95% CI, -0.38 to -0.09)] after exposure to diabetes health coaching, and small to trivial significant benefits for BMI, waist circumference, body weight, and depression/distress immediately post intervention based on moderate certainty of evidence. However, long term benefit of these clinical outcomes were not maintained at follow-up timepoints. There was a small significant benefit for systolic blood pressure which was maintained after the completion of health coaching exposure at follow-up, but there was no statistically significant benefit in other secondary outcomes such as diastolic blood pressure and lipid profile measures (e.g. triglycerides). Very few studies reported on other quadruple aim measures such as patient-reported outcomes, cost of care, and healthcare provider experience.
Our systematic review and meta-analysis shows that health coaching interventions can have short term impact beyond glucose control on cardiometabolic and mental health outcomes. Future studies should try to examine quadruple aim outcomes to better assess the benefit and impact of these interventions at longer time points and following termination of the coaching program.
https://www.crd.york.ac.uk/prospero, identifier (CRD42022347478).
We searched 6 databases for randomized controlled trials of health coaching interventions delivered by a health professional for adults with T2DM. Reviewers screened citations, extracted data, and assessed risk of bias and certainty of evidence (GRADE). We assessed statistical and methodological heterogeneity and performed a meta-analysis of studies.
Nine studies were included in this review. Our meta-analysis showed a significant reduction of A1C [0.24 (95% CI, -0.38 to -0.09)] after exposure to diabetes health coaching, and small to trivial significant benefits for BMI, waist circumference, body weight, and depression/distress immediately post intervention based on moderate certainty of evidence. However, long term benefit of these clinical outcomes were not maintained at follow-up timepoints. There was a small significant benefit for systolic blood pressure which was maintained after the completion of health coaching exposure at follow-up, but there was no statistically significant benefit in other secondary outcomes such as diastolic blood pressure and lipid profile measures (e.g. triglycerides). Very few studies reported on other quadruple aim measures such as patient-reported outcomes, cost of care, and healthcare provider experience.
Our systematic review and meta-analysis shows that health coaching interventions can have short term impact beyond glucose control on cardiometabolic and mental health outcomes. Future studies should try to examine quadruple aim outcomes to better assess the benefit and impact of these interventions at longer time points and following termination of the coaching program.
https://www.crd.york.ac.uk/prospero, identifier (CRD42022347478).
摘要：
未经评估：糖尿病自我管理需要终身学习，行为改变,支持,和监测,健康指导是一种有希望的干预措施,不仅可以帮助个体达到血糖目标和糖化血红蛋白(A1C)目标.目前,2型糖尿病(T2DM)的健康指导研究因其对血糖控制的重视而受到限制.本系统评价和荟萃分析的目的是根据四重目标结果确定健康指导对成人T2DM的影响，并评估这些干预措施的实施。
UNASSIGNED：我们在6个数据库中搜索了由健康专业人员为成人T2DM提供的健康指导干预的随机对照试验。审稿人筛选了引文，提取的数据，并评估偏倚风险和证据确定性(等级)。我们评估了统计学和方法学异质性，并对研究进行了荟萃分析。
UNASSIGNED：本综述包括9项研究。我们的荟萃分析显示，暴露于糖尿病健康指导后，A1C显着降低[0.24（95％CI，-0.38至-0.09）]，对于BMI来说，小到微不足道的好处，腰围,体重,根据证据的适度确定性，干预后立即出现抑郁/痛苦。然而,在随访时间点,这些临床结局的长期获益并未维持.在随访时完成健康教练暴露后，收缩压有很小的显着益处，但在其他次要结局如舒张压和血脂指标(如甘油三酯)方面无统计学显著获益.很少有研究报告其他四重目标措施，如患者报告的结果，护理费用，和医疗保健提供者的经验。
UNASSIGNED：我们的系统评价和荟萃分析显示，健康教练干预措施可以对心脏代谢和心理健康结果产生超越血糖控制的短期影响。未来的研究应尝试检查四重目标结果，以更好地评估这些干预措施在较长时间点和终止指导计划后的益处和影响。
UNASSIGNED：https://www。crd.约克。AC.英国/普劳里,标识符(CRD4202234478)。
UNASSIGNED：我们在6个数据库中搜索了由健康专业人员为成人T2DM提供的健康指导干预的随机对照试验。审稿人筛选了引文，提取的数据，并评估偏倚风险和证据确定性(等级)。我们评估了统计学和方法学异质性，并对研究进行了荟萃分析。
UNASSIGNED：本综述包括9项研究。我们的荟萃分析显示，暴露于糖尿病健康指导后，A1C显着降低[0.24（95％CI，-0.38至-0.09）]，对于BMI来说，小到微不足道的好处，腰围,体重,根据证据的适度确定性，干预后立即出现抑郁/痛苦。然而,在随访时间点,这些临床结局的长期获益并未维持.在随访时完成健康教练暴露后，收缩压有很小的显着益处，但在其他次要结局如舒张压和血脂指标(如甘油三酯)方面无统计学显著获益.很少有研究报告其他四重目标措施，如患者报告的结果，护理费用，和医疗保健提供者的经验。
UNASSIGNED：我们的系统评价和荟萃分析显示，健康教练干预措施可以对心脏代谢和心理健康结果产生超越血糖控制的短期影响。未来的研究应尝试检查四重目标结果，以更好地评估这些干预措施在较长时间点和终止指导计划后的益处和影响。
UNASSIGNED：https://www。crd.约克。AC.英国/普劳里,标识符(CRD4202234478)。
