背景:糖尿病是一种可能导致失明的慢性疾病,肾衰竭,心脏病发作,笔画,下肢截肢.糖尿病的全球患病率正在上升,特别是在撒哈拉以南非洲(SSA)地区,在那里获得治疗和抗糖尿病药物是复杂的,导致在管理条件方面的挑战。有意和结构化的治疗教育已证明了其增强糖尿病患者健康结果的能力。鉴于撒哈拉以南非洲的众多医疗保健缺陷,作者重新评估了治疗性患者教育(TPE)在这方面的作用.
方法:本系统评价遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。我们在2023年3月14日至6月30日之间查询了四个数据库,并对纳入的研究进行了Cochrane的偏差风险分析。随后,对结果进行了定性合成。
结果:最终分析包括13项研究。其中七个,评估血糖控制,报告了具有统计学意义的结果。此外,其他临床参数,如体重指数(BMI),血压,和脂质水平也表现出一些显著的改善。干预后知识大幅增加,而态度,自我保健的做法,和药物依从性没有显着改善。护士主导和同伴主导的干预计划产生了积极的结果,而基于技术的干预方法没有产生良好的结果.
结论:撒哈拉以南非洲的TPE项目对糖尿病患者的临床和非临床结局都有显著影响。然而,这些结果的可持续性仍然不确定。需要进一步的研究来评估TPE对糖尿病患者的长期影响。
BACKGROUND: Diabetes is a chronic disease associated with the potential for blindness, kidney failure, heart attacks, strokes, and lower limb amputations. The global prevalence of diabetes is rising, particularly in the sub-Saharan African (SSA) region, where accessing treatment and antidiabetic drugs is complex, leading to challenges in managing the condition. Intentional and structured therapeutic education has demonstrated its ability to enhance health outcomes in diabetes patients. Given the numerous healthcare deficiencies in sub-Saharan Africa, the authors have reevaluated the role of therapeutic patient education (TPE) in this context.
METHODS: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We queried four databases between March 14 and June 30, 2023 and conducted Cochrane\'s Risk of Bias analysis on the included studies. Subsequently, a qualitative synthesis of the results was performed.
RESULTS: The final analysis included thirteen studies. Seven of these, which assessed glycemic control, reported statistically significant results. Additionally, other clinical parameters such as body mass index (BMI), blood pressure, and lipid levels also exhibited some significant improvements. Knowledge substantially increased following the intervention, while attitude, self-care practices, and medication adherence showed no significant improvements. Nurse-led and peer-led intervention programs produced positive outcomes, whereas technology-based intervention methods did not yield favorable results.
CONCLUSIONS: TPE programs in sub-Saharan Africa have a significant impact on both clinical and non-clinical outcomes in diabetes patients. However, the sustainability of these outcomes remains uncertain. Further research is needed to assess the long-term effects of TPE on diabetes patients.