AUTHOR=Asmat Kainat , Dhamani Khairunnisa , Gul Raisa , Froelicher Erika Sivarajan 

TITLE=The effectiveness of patient-centered care vs. usual care in type 2 diabetes self-management: A systematic review and meta-analysis

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.994766

DOI=10.3389/fpubh.2022.994766

ISSN=2296-2565

ABSTRACT=Background: Patient-centered care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes yet the supporting evidence is inadequate. This review is aimed to assess the effectiveness of patient-centered self-management care interventions on glycemic control (HbA1c) and self-care behaviors compared with usual care. 
Methods: CINAHL, PubMed, Cochrane Library, Google Scholar and the HEC digital library were searched for English language studies that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or above with type 2 diabetes from 2005 to 2020. Interventional studies with at least three months of follow-up and reporting on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors including diet control, physical activity, foot care and medication adherence were included. 
Results:  Of the 168 identified records, 24 were found eligible comprising 20 RCTs and 4 QESs with total 4,083 participants. The meta-analysis involved 19 RCTs that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c −0.56 (95% CI −0.79, −0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components −0.66 (95% CI −0.97, −0.34), spanned over shorter (<03 months) duration −0.85 (95% CI −1.28, −0.43), administered by nurses −0.80 (95% CI −1.44, −0.16) and delivered in community setting −0.70 (95% CI −1.14, −0.26). 
Conclusion: This systematic review provided evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing towards success.