Purpose

The purpose of this umbrella review was to synthesize the evidence from published systematic reviews on the effectiveness of text message programs for adults with type 2 diabetes (T2DM) on glycemic management (A1C), self-management, and other clinical outcomes. The effect of directionality of the program was also explored.

Methods

A systematic search was conducted using multiple databases. Inclusion criteria were systematic review of text message programs for adults with T2DM, evaluated A1C, and English language. Quality assessment was completed using AMSTAR-2 guidelines. Data were extracted by multiple coders, and results were synthesized.

Results

The final sample included 9 systematic reviews published between 2011 and 2019, with 72 unique international studies. Text message programs focused on diabetes self-management and reducing health risks through educational and motivational content with some providing personalized feedback. A meta-analysis of program effect on A1C was conducted in 5 reviews with a pooled difference in A1C from −0.38% to −0.8%. Adults with T2DM of shorter duration and lower A1C had better treatment effects. Evidence on unidirectional versus bidirectional programs is conflicting; however, both improve outcomes. Evidence of text message programs targeting medication engagement was inconclusive. Some programs improved blood pressure, lipids, self-management, self-efficacy, and health behaviors. High satisfaction and an average of 9.6% to 18.7% attrition was reported.

Conclusions

Text messaging programs can improve T2DM outcomes, are a highly accessible mode of communication, are relatively inexpensive, and are an underutilized adjunct to clinical care.

中文翻译：

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成人2型糖尿病文本消息程序的伞评论

目的

这项总括性综述的目的是综合来自已发表的系统综述的证据，该综述涉及文本消息程序对2型糖尿病（T2DM）成人在血糖管理（A1C），自我管理和其他临床结果方面的有效性。该程序的方向性的影响也进行了探讨。

方法

使用多个数据库进行了系统的搜索。纳入标准是对患有T2DM，评估为A1C和英语的成年人的短信程序的系统评价。使用AMSTAR-2指南完成了质量评估。通过多个编码器提取数据，并对结果进行合成。

结果

最终样本包括2011年至2019年发表的9篇系统评价，以及72篇独特的国际研究。短信计划专注于糖尿病的自我管理，并通过教育和激励性内容降低了健康风险，其中一些提供个性化反馈。在5条评论中对程序对A1C的影响进行了荟萃分析，汇总了A1C从-0.38％到-0.8％的差异。持续时间较短，A1C较低的T2DM成人具有更好的治疗效果。关于单向程序和双向程序的证据相互矛盾；但是，两者都能改善结果。针对药物治疗的短信程序的证据尚无定论。一些程序改善了血压，血脂，自我管理，自我效能和健康行为。据报道，满意度很高，平均损耗率为9.6％至18.7％。

结论

文本消息传递程序可以改善T2DM的结果，是一种高度可访问的通信方式，相对便宜，并且是临床护理中未被充分利用的附件。