The impact of health literacy interventions on glycemic control and self‐management outcomes among type 2 diabetes mellitus: A systematic review Translated title: 健康素养干预对2型糖尿病患者血糖控制和自我管理结果的影响:一项系统综述

Abstract

Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity and mortality of type 2 diabetes mellitus (T2DM). Self‐management is the primary tool for managing diabetes. Health literacy (HL) is the primary driver of self‐management activities. The aim of this review is to evaluate the impact of HL interventions on glycemic control and self‐management outcomes among T2DM. MEDLINE, CINAHL, PubMed, Cochrane, Scopus, and Web of Science were searched for eligible papers. Fifteen randomized controlled trials published in English between 1997 and 2021, used HL‐driven intervention, and measured the level of glycohemoglobin A1c (HbA1c) and self‐management of T2DM patients were included in this review. The findings showed that HL‐driven intervention had a positive impact on glycemic control and improved self‐management behaviors. The level of glycemic control and self‐management skills were improved through individual and telephone‐based intervention respectively. Community worker‐led interventions were effective in improvements in diabetes knowledge and self‐care behaviors; however, nurse‐led interventions were effective in glycemic control. Better glycemic control is achieved in hospital settings compared to outpatient settings. HL interventions yielded better improvement in self‐management among people with longer diabetes duration (more than 7 years). It was possible to achieve a large reduction in HbA1c level after a 3‐month intervention in hospital settings. HL‐driven interventions are effective in glycemic and diabetes self‐management outcomes.

Abstract

Highlights

• Health literacy (H)L‐driven interventions were effective in controlling glycemic levels and improving diabetes self‐management outcomes.

• The level of glycemic control and self‐management skills were improved better through individual and telephone‐based intervention, respectively, in comparing group intervention.

• Community worker led interventions were effective in improvements in diabetes knowledge and self‐care behaviors; however, nurse‐led interventions were more effective in glycemic control.

• Better glycemic control was achieved in hospital settings compared with outpatient settings.

• HL interventions yielded better improvement in self‐management among people with a longer diabetes duration (more than 7 years) than those with short duration of diabetes.

• It was possible to achieve a significant reduction in HbA1c level after a 3‐month intervention in hospital settings.

摘要

糖尿病给世界范围内的患者和社会带来了日益严重的健康和经济负担。控制血糖是降低2型糖尿病(T2DM)发病率和死亡率的必要条件。自我管理是糖尿病管理的主要手段。健康知识(HL)是自我管理活动的主要动力。本综述旨在评估HL干预对2型糖尿病患者血糖控制和自我管理结果的影响。通过检索MEDLINE、CINAHL、PubMed、Cochrane、Scopus和Web of Science，本综述共纳入1997—2021年发表的15篇英文形式发表的采用HL驱动干预，并监测2型糖尿病患者糖化血红蛋白(HbA _1c)和自我管理水平的随机对照试验。研究结果表明，健康素养干预对血糖控制和改善自我管理行为产生积极的影响。通过个人干预和电话干预能够提高患者血糖控制水平和自我管理能力。社区工作者主导的干预措施在改善糖尿病知识和自我护理行为方面是有效的；护士主导的干预措施对血糖控制有效。与门诊患者相比，住院患者的血糖控制效果更好。在糖尿病病程较长(超过7年)的人群中，HL干预能更好地改善自我管理。在医院环境中，经过3个月的干预，HbA _1c水平有可能大幅降低。HL驱动的干预措施对血糖和糖尿病自我管理结果有效。