Meta-analysis of telemonitoring to improve HbA1c levels: promise for stroke survivors

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Bryan A LieberE Sander Connolly

Abstract

Monitoring glycemic control is useful not only in the primary prevention of stroke in diabetics, but also in the rehabilitation from and secondary prevention of stroke. In an often functionally and neurocognitively impaired population, however, poor compliance with treatment regimens is a major problem. Wireless, telemonitoring glucometers - often integrated into the patient's healthcare system - offer a solution to the compliance issue. We sought to evaluate the effectiveness of telemonitoring technologies in improving long-term glycemic control. A search on www.clinicaltrials.gov, using keywords such as "telemonitoring" and "self-care device" was performed, and five trials were identified that compared hemoglobin A1c (HbA1c) levels of a group receiving standard care (controls) to a group receiving a telemonitoring intervention. Four of the five studies showed a greater reduction in HbA1c in the intervention group compared to controls at 6 months, although only one was statistically significant. There was considerable heterogeneity between studies (I(2)=69.5%, p=0.02), and the random effects model estimated the aggregate effect size for mean difference in reduction of HbA1c levels to be 0.08% (95% confidence interval -0.12% to...Continue Reading

References

Feb 1, 1985·Southern Medical Journal·R Harris, M W Linn
Sep 11, 2002·Neurology·A BrunoUNKNOWN NINDS rt-PA Stroke Study Group
May 17, 2003·Stroke; a Journal of Cerebral Circulation·Thomas HillenUNKNOWN South London Stroke Register
Oct 9, 2003·JAMA : the Journal of the American Medical Association·K M Venkat NarayanDavid F Williamson
Nov 1, 2003·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Neil SprattJanet Fisher
Sep 24, 2005·Annals of Medicine·Claudia StöllbergerChristina Steger
Feb 16, 2006·Seminars in Neurology·Brett Kissela, Ellen Air
May 27, 2006·Stroke; a Journal of Cerebral Circulation·Per HarmsenLars Wilhelmsen
Jul 5, 2007·BMC Medical Research Methodology·Rob McCarneyPeter Fisher
Jan 22, 2008·Lancet Neurology·Geert Jan BiesselsChristopher M Ryan
Feb 2, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Joyce A CramerPeter K Wong
Jan 6, 2009·Diabetes Care·UNKNOWN American Diabetes Association
Jun 13, 2009·Stroke; a Journal of Cerebral Circulation·Kjell AsplundUNKNOWN MORGAM Project
Feb 22, 2012·Lancet Neurology·Merel J A LuitseL Jaap Kappelle
Mar 3, 2012·Stroke; a Journal of Cerebral Circulation·Chirantan BanerjeeMitchell S V Elkind
May 25, 2013·Stroke; a Journal of Cerebral Circulation·Jean-Philippe DesillesMikael Mazighi
Jul 1, 2011·Journal of Primary Care & Community Health·M Diane McKeeElizabeth A Walker
Jul 4, 2013·JAMA : the Journal of the American Medical Association·Karen L MargolisNicole K Trower
Dec 20, 2013·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Feb 18, 2014·International Journal of Medical Informatics·Joana CruzAlda Marques
Apr 15, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Susanne FonvilleHester F Lingsma

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Citations

Feb 7, 2018·International Journal of Environmental Research and Public Health·Marit SkogstadØivind Skare
Oct 20, 2018·Current Diabetes Reports·Yilin YoshidaEduardo J Simoes
Nov 18, 2018·The Journal of International Medical Research·Ebtisam A Al-OfiSarah M Ghazali
Oct 6, 2018·Journal of Diabetes and Metabolic Disorders·Ali BijaniReza Ghadimi
Jun 1, 2021·International Journal of Medical Informatics·Miloš AjčevićPaolo Manganotti
Jun 30, 2021·Journal of Telemedicine and Telecare·Centaine L SnoswellAnthony C Smith

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