Digital Health Professions Education on Diabetes Management: Systematic Review by the Digital Health Education Collaboration.

Zhilian Huang, Monika Semwal, Shuen Yee Lee, Mervin Tee, William Ong, Woan Shin Tan, Ram Bajpai, Lorainne Tudor Car
Author Information
  1. Zhilian Huang: Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. ORCID
  2. Monika Semwal: Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. ORCID
  3. Shuen Yee Lee: Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore. ORCID
  4. Mervin Tee: School of Mechanical Aerospace and Engineering, Nanyang Technological University Singapore, Singapore, Singapore. ORCID
  5. William Ong: Institute for Health Technologies (HealthTech NTU), Interdisciplinary Graduate School, Nanyang Technological University Singapore, Singapore, Singapore. ORCID
  6. Woan Shin Tan: Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. ORCID
  7. Ram Bajpai: Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. ORCID
  8. Lorainne Tudor Car: Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. ORCID

Abstract

BACKGROUND: There is a shortage of health care professionals competent in diabetes management worldwide. Digital education is increasingly used in educating health professionals on diabetes. Digital diabetes self-management education for patients has been shown to improve patients' knowledge and outcomes. However, the effectiveness of digital education on diabetes management for health care professionals is still unknown.
OBJECTIVE: The objective of this study was to assess the effectiveness and economic impact of digital education in improving health care professionals' knowledge, skills, attitudes, satisfaction, and competencies. We also assessed its impact on patient outcomes and health care professionals' behavior.
METHODS: We included randomized controlled trials evaluating the impact of digitalized diabetes management education for health care professionals pre- and postregistration. Publications from 1990 to 2017 were searched in MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL, ERIC, and Web of Science. Screening, data extraction and risk of bias assessment were conducted independently by 2 authors.
RESULTS: A total of 12 studies met the inclusion criteria. Studies were heterogeneous in terms of digital education modality, comparators, outcome measures, and intervention duration. Most studies comparing digital or blended education to traditional education reported significantly higher knowledge and skills scores in the intervention group. There was little or no between-group difference in patient outcomes or economic impact. Most studies were judged at a high or unclear risk of bias.
CONCLUSIONS: Digital education seems to be more effective than traditional education in improving diabetes management-related knowledge and skills. The paucity and low quality of the available evidence call for urgent and well-designed studies focusing on important outcomes such as health care professionals' behavior, patient outcomes, and cost-effectiveness as well as its impact in diverse settings, including developing countries.

Keywords

References

  1. Endocr Pract. 2012 Mar-Apr;18(2):238-49 [PMID: 22440993]
  2. Acad Med. 1990 Sep;65(9 Suppl):S63-7 [PMID: 2400509]
  3. BMJ. 2015 Jan 02;350:g7647 [PMID: 25555855]
  4. BMC Med Educ. 2017 Aug 8;17(1):131 [PMID: 28789690]
  5. J Med Internet Res. 2019 Feb 14;21(2):e12913 [PMID: 30762583]
  6. Health Technol Assess. 2011 Aug;15(29):1-202 [PMID: 21851764]
  7. J Clin Epidemiol. 2013 Feb;66(2):173-83 [PMID: 23116689]
  8. Am J Prev Med. 2016 Jan;50(1):122-128 [PMID: 26602941]
  9. Ann Ist Super Sanita. 2014;50(4):309-10 [PMID: 25522068]
  10. J Diabetes Sci Technol. 2012 Sep 01;6(5):1197-206 [PMID: 23063047]
  11. Diabetes Care. 2010 Aug;33(8):1727-33 [PMID: 20668151]
  12. BMJ. 2011 Oct 18;343:d5928 [PMID: 22008217]
  13. J Med Assoc Thai. 2007 Jul;90(7):1430-4 [PMID: 17710988]
  14. Acad Med. 2014 Dec;89(12):1664-73 [PMID: 25006707]
  15. Pediatr Diabetes. 2009 Nov;10(7):474-83 [PMID: 19490492]
  16. Acta Psychiatr Scand. 2009 Jun;119(6):443-50 [PMID: 19469725]
  17. Diabetes Care. 2009 Apr;32(4):585-90 [PMID: 19171723]
  18. Diabet Med. 2017 Aug;34(8):1074-1083 [PMID: 28195662]
  19. J Gen Intern Med. 2006 Feb;21(2):105-10 [PMID: 16390512]
  20. BMC Med Educ. 2011 Jun 16;11:35 [PMID: 21679446]
  21. Diabetes Care. 2016 Nov;39(11):2089-2095 [PMID: 27926892]
  22. J Med Internet Res. 2017 Mar 09;19(3):e72 [PMID: 28279950]
  23. Int J Qual Health Care. 2011 Dec;23(6):682-9 [PMID: 21831967]
  24. Acad Med. 2010 May;85(5):909-22 [PMID: 20520049]
  25. JAMA. 2008 Sep 10;300(10):1181-96 [PMID: 18780847]
  26. BMC Med Educ. 2013 Oct 03;13:135 [PMID: 24090039]
  27. South Med J. 2015 Sep;108(9):510-5 [PMID: 26332473]
  28. J Glob Health. 2014 Jun;4(1):010406 [PMID: 24976965]
  29. Acad Med. 2010 Sep;85(9):1511-7 [PMID: 20736679]
  30. J Am Med Inform Assoc. 1994 Sep-Oct;1(5):372-80 [PMID: 7850561]
  31. BMJ Open. 2012 Sep 17;2(5): [PMID: 22991217]

MeSH Term

Diabetes Mellitus
Health Education
Health Personnel
Humans

Word Cloud

Created with Highcharts 10.0.0educationhealthdiabetescareDigitaloutcomesimpactprofessionalsknowledgedigitalstudiesmanagementprofessionals'skillspatienteffectivenesseconomicimprovingbehaviorriskbiasinterventiontraditionalHealthEducationBACKGROUND:shortagecompetentworldwideincreasinglyusededucatingself-managementpatientsshownimprovepatients'HoweverstillunknownOBJECTIVE:objectivestudyassessattitudessatisfactioncompetenciesalsoassessedMETHODS:includedrandomizedcontrolledtrialsevaluatingdigitalizedpre-postregistrationPublications19902017searchedMEDLINEEMBASECochraneLibraryPsycINFOCINAHLERICWebScienceScreeningdataextractionassessmentconductedindependently2authorsRESULTS:total12metinclusioncriteriaStudiesheterogeneoustermsmodalitycomparatorsoutcomemeasuresdurationcomparingblendedreportedsignificantlyhigherscoresgrouplittlebetween-groupdifferencejudgedhighunclearCONCLUSIONS:seemseffectivemanagement-relatedpaucitylowqualityavailableevidencecallurgentwell-designedfocusingimportantcost-effectivenesswelldiversesettingsincludingdevelopingcountriesProfessionsDiabetesManagement:SystematicReviewCollaborationmellitusevidence-basedpracticepersonnellearningsystematicreview

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