Evidence map›Paper›PMID 21149524›Full record

SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2011

Effectiveness of disease-management programs for improving diabetes care: a meta-analysis.

Clément Pimouguet, Mélanie Le Goff, Rodolphe Thiébaut, Jean François Dartigues, Catherine Helmer

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03466398 (Effects of a Remote Patient Monitoring Protocol on Glycemic Control in Adolescents With Type 1 Diabetes), which is not on this map. Cited by 99 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 20 pooled it
10.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03466398 nawithdrawnnot on this mapstarted 2018, after this paper: background citation

Effects of a Remote Patient Monitoring Protocol on Glycemic Control in Adolescents With Type 1 Diabetes

TypeinterventionalSponsorUniversity of Texas Southwestern Medical CenterRan2018 to 2020Enrolled0ConditionsDiabetes Mellitus, Type 1 Diabetes MellitusArmsVivify Health RPM Protocol
3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 20 syntheses or guidelines pooled it, 289 citations in OpenAlex.

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  9. Chronic disease management interventions for people with chronic kidney disease in primary care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018
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  14. Chronic disease management programmes for adults with asthma.The Cochrane database of systematic reviews · 2015
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39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Clément PimouguetInstitut national de la santé et de la recherche médicale, Bordeaux, France. clement.pimouguet@ispe.u-bordeaux2.fr
Mélanie Le Goff
Rodolphe Thiébaut
Jean François Dartigues
Catherine Helmer
Inserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe conducted a meta-analysis of randomized controlled trials to assess the effectiveness of disease-management programs for improving glycemic control in adults with diabetes mellitus and to study which components of programs are associated with their effectiveness.

methodsWe searched several databases for studies published up to December 2009. We included randomized controlled trials involving adults with type 1 or 2 diabetes that evaluated the effect of disease-management programs on glycated hemoglobin (hemoglobin A₁(C)) concentrations. We performed a meta-regression analysis to determine the effective components of the programs.

resultsWe included 41 randomized controlled trials in our review. Across these trials, disease-management programs resulted in a significant reduction in hemoglobin A₁(C) levels (pooled standardized mean difference between intervention and control groups -0.38 [95% confidence interval -0.47 to -0.29], which corresponds to an absolute mean difference of 0.51%). The finding was robust in the sensitivity analyses based on quality assessment. Programs in which the disease manager was able to start or modify treatment with or without prior approval from the primary care physician resulted in a greater improvement in hemoglobin A₁(C) levels (standardized mean difference -0.60 v. -0.28 in trials with no approval to do so; p < 0.001). Programs with a moderate or high frequency of contact reported a significant reduction in hemoglobin A₁(C) levels compared with usual care; nevertheless, only programs with a high frequency of contact led to a significantly greater reduction compared with low-frequency contact programs (standardized mean difference -0.56 v. -0.30, p = 0.03).

interpretationDisease-management programs had a clinically moderate but significant impact on hemoglobin A₁(C) levels among adults with diabetes. Effective components of programs were a high frequency of patient contact and the ability for disease managers to adjust treatment with or without prior physician approval.

Indexed as

Disease ManagementOutcome and Process Assessment, Health CareAdultDiabetes MellitusHumansPatient Education as TopicProfessional AutonomyRandomized Controlled Trials as TopicRegression AnalysisSocial Support

Identifiers

PMID21149524
PMCPMC3033953
OpenAlexW1999162865

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.