Table 1.
Characteristics of the studies included for the systematic review: interventions targeting diabetes.a
| Study | Setting and study length | Participants | Age (years), mean (SD) | Sex (% female) | Intervention | Control | Primary; secondary outcomes |
| Bond 2010 [42] | 2-arm RCT; USA; 6 m | 62 people with DM via university/veteran clinic | 67.2 (6.0) | 45 | Website: education, self-monitoring (glucose, exercise, weight, BP, medication), forum; nurse support (email, chat) | Standard diabetes care | HbA1c, BP, weight, total cholesterol, HDL cholesterol |
| IDEATEL 2000-2010 [34] | 2-arm RCT; USA; 60 m | 1665 Medicare recipients with DM | 70.9 (6.7) | 63 | Online home telemedicine unit: nurse support (video chat), Web portal for self-monitoring (glucose, BP), education | Standard diabetes care | HbA1c, systolic BP, diastolic BP, total cholesterol, LDL cholesterol |
| D-net 2001 [43] | 4-arm RCT; USA; 10 m | 320 people with DM2, Internet, from 16 GPs | 59 (9.2) | 53 | Website: (1) Self-management (glucose), coach support; (2) education, forum; (3) 1 and 2 combinedb | (4) Information on medical and lifestyle aspects of diabetes | Not defined; behavioral, biological, and psychosocial outcomes |
| My path 2010 [44] | 3-arm RCT; USA; 12 m | 463 Medicare recipients with DM2, BMI ≥25 kg/m2 or ≥1 CV risk factor, Internet | 58.4 (9.2) | 50 | (1) Website for computer-assisted self-management(CASM): goal setting, monitoring (HbA1c, BP, cholesterol), forum, education;b,c (2) CASM+ social support (coach, group sessions)b,c | (3) Computer-based health risk appraisal, no key features of CASM | Behavior changes in diet, physical activity, medication adherence |
| My care team 2005 [45] | 2-arm RCT; USA; 12 m | 104 people with DM, HbA1c ≥9.0% via veteran clinic | 63.5 (7.0) | 0.5 | Website: self-management (glucose, BP), education, reminders (phone); care manager support | DM self-management training, usual care | HbA1c and BP at 3, 6, 9, and 12 m |
| Mobile DM 2011 [32] | 4-arm cluster RCT; USA; 12 m | 26 physician practices with 163 people with DM and HbA1c ≥7.5% | 52.8 (8.1) | 50 | (2) Self-management via website + mobile phone, patient informs doctor;b (3) 2 + doctor access to data; (4) 3 + advice from doctorc | (1) Care as usual | Change in HbA1c over 1 year |
| Avdal 2011 [46] | 2-arm RCT; Turkey; 6 m | 122 people with DM2, Internet from clinic | 51 (7.3) | 51 | Website: review risk profile, messaging to researcher, daily glucose monitoring | Education and usual care | HbA1c, attendance rates at outpatient clinic |
| Cho 2006 [47] | 2-arm RCT; South Korea; 30 m | 80 people with DM, Internet from clinic | 53 (9) | 39 | Website: monitoring (glucose, medication, BP, weight, lifestyle), nurse feedback, medication alterations | Conventional note-keeping record system | HbA1c and HbA1c fluctuation index |
| Lorig 2010 [48] | 3-arm RCT; USA; 6 m | 761 people with DM2, Internet | 54.3 (9.9) | 73 | Self-management website with peer support: lessons, action plans, bulletin board, messaging | Care as usual | HbA1C level at 6 and 18 months |
| Grant 2008 [49] | 2-arm cluster RCT; USA; 12 m | 244 people with DM, HbA1c >7.0% from 11 primary clinics | 56.1 (11.6) | 49 | Online personal health record: education, diabetes care plan, agenda, messaging, prescription refills | Access to general website Patient Gateway | Changes in HbA1c, BP, and LDL cholesterol |
| McMahon 2012 [50] | 3-arm RCT; USA; 12 m | 151 people with DM, HbA1c>8.5% from veteran health services | 60.2 (10.8) | 5 | (1) Self-monitoring via phone (BP, glucose); (2) website: self-monitoring (BP, glucose), education, support by care managersb,c | (3) Website with links to other DM websites; usual care | Change in HbA1c and BP over time |
| Ralston 2009 [51] | 2-arm RCT; USA; 12 m | 83 people with DM2, HbA1c≥7.0% and Internet from clinic: 65% with 2 CV risk factors | 57.3 (—) | 52 | Electronic medical record: self-monitoring (glucose, exercise, diet, medication), support by care manager, usual care visits | Usual care visits | Change in HbA1c |
| Kwon 2004 [52] | 2-arm RCT; South Korea; 3 m | 110 people with DM2, Internet from clinic: 27% hypertension | 54.1 (9.1) | 33 | Website: self-monitoring (glucose), reminders, professor/nurse/dietician-support | Monthly visit to diabetes specialist | HbA1c |
| EMPOWER-D 2013 [39] | 2-arm RCT; USA; 12 m | 415 people with DM and HbA1c ≥7.5% from clinic | 53.7 (10.2) | 40 | Online health record: risk estimation, self-monitoring (glucose, diet, exercise, BP), nurse support, own doctor informed | Usual care | HbA1c at 12 m |
| REDEEM 2013 [53] | 3-arm RCT; USA; 12 m | 392 people with DM2, Internet from community centers | 56.1 (9.6) | 54 | (1) CASM website: goal setting; self-monitoring (HbA1c, BP, cholesterol); 8 phone calls;b (2) Computer-assisted self-management + problem solving treatment (CASP): CASM + 8 sessions problem solving | Computer health risk appraisal, education, same phone calls as intervention | Diabetes distress; HbA1c, physical activity, medication compliance |
a Abbreviations: BP: blood pressure; CASM: computer-assisted self-management; CASP: computer-assisted self-management + problem solving treatment; CV: cardiovascular; DM: diabetes mellitus; DM2: type 2 diabetes mellitus; GP: general practitioner; HbA1c; glycated hemoglobin A1c; HDL: high-density lipoprotein; LDL: low-density lipoprotein.
b For studies with more than 2 arms, this arm was used for all analyses.
c For studies with more than 2 arms, this arm was used for the subgroup analysis on blended interventions.