Table 3:
Pooled estimates of the effect of telemedicine on outcomes
| Outcome | Time point, mo | No. of trials and within-trial subgroups (no. of participants*) | I2 statistic, % | Pooled estimate (95% CI) |
|---|---|---|---|---|
| Mortality | ≤ 3 | 11 (1361) | 0 | RD,%: 0.2 (−0.6 to 0.9) |
| 4–12 | 42 (7197) | 0 | RD,%: −0.2 (−0.6 to 0.2) | |
| > 12 | 4 (2376) | 0 | RD,%: −0.3 (−1.6 to 1.0) | |
| HbA1C | ||||
| HbA1C level, % | ≤ 3 | 39 (3165) | 75 | MD, %: −0.57 (−0.74 to −0.40) |
| 4–12 | 87 (15 524) | 69 | MD, %: −0.28 (−0.37 to −0.20) | |
| > 12 | 5 (1896) | 58 | MD, %: −0.26 (−0.46 to −0.06) | |
| HbA1C < 6.4% or < 6.5% | 4–12 | 1 (248) | – | RR: 1.79 (0.98 to 3.27) |
| > 12 | 1 (80) | – | RR: 2.33 (0.997 to 5.46) | |
| HbA1C < 7%, ≤ 7% or ≤ 7.5% | ≤ 3 | 7 (1016) | 91 | RR: 2.30 (1.21 to 4.38) |
| 4–12 | 11 (1615) | 73 | RR: 1.46 (1.03 to 2.08) | |
| HbA1C < 8% or ≤ 8% | ≤ 3 | 1 (137) | – | RR: 2.28 (1.42 to 3.67) |
| 4–12 | 3 (602) | 72 | RR: 1.20 (0.90 to 1.61) | |
| HbA1C < 9% | ≤ 3 | 1 (137) | – | RR: 1.31 (1.07 to 1.60) |
| 4–12 | 1 (137) | – | RR: 1.26 (1.04 to 1.52) | |
| SF-36 (0–100)† | ||||
| Mental component summary | ≤ 3 | 2 (295) | 0 | MD: −1.06 (−3.19 to 1.07) |
| 4–12 | 4 (784) | 63 | MD: 0.47 (−1.89 to 2.84) | |
| Physical component summary | ≤ 3 | 2 (295) | 42 | MD: 0.92 (−1.97 to 3.81) |
| 4–12 | 4 (784) | 0 | MD: 0.08 (−1.16 to 1.32) | |
| Bodily pain | ≤ 3 | 2 (309) | 86 | MD: 5.46 (−8.64 to 19.56) |
| 4–12 | 6 (1166) | 19 | MD: 0.44 (−2.19 to 3.07) | |
| General health | ≤ 3 | 2 (306) | 0 | MD: 0.97 (−1.42 to 3.37) |
| 4–12 | 6 (1163) | 58 | MD: 1.12 (−2.07 to 4.32) | |
| Health transition | 4–12 | 1 (117) | – | MD: 3.00 (−6.00 to 12.00) |
| Mental health | ≤ 3 | 2 (308) | 0 | MD: −1.09 (−3.19 to 1.01) |
| 4–12 | 7 (1285) | 62 | MD: 2.31 (−0.24 to 4.86) | |
| Physical functioning | ≤ 3 | 2 (311) | 30 | MD: −3.98 (−7.34 to −0.62) |
| 4–12 | 7 (1288) | 58 | MD: 1.06 (−1.52 to 3.64) | |
| Role emotional | ≤ 3 | 2 (304) | 0 | MD: −1.00 (−3.50 to 1.51) |
| 4–12 | 6 (1161) | 80 | MD: 2.89 (−4.96 to 10.74) | |
| Role physical | ≤ 3 | 2 (307) | 0 | MD: 0.30 (−2.38 to 2.97) |
| 4–12 | 6 (1164) | 62 | MD: 2.20 (−3.62 to 8.02) | |
| Social functioning | ≤ 3 | 2 (311) | 0 | MD: −2.22 (−4.34 to −0.10) |
| 4–12 | 6 (1168) | 59 | MD: −0.27 (−3.78 to 3.24) | |
| Vitality | ≤ 3 | 2 (310) | 0 | MD: 0.50 (−1.98 to 2.98) |
| 4–12 | 6 (1167) | 69 | MD: 1.57 (−2.26 to 5.40) | |
| SF-12 (0–100)† | 4–12 | 1 (35) | – | MD: −1.00 (−2.33 to 0.33) |
| Mental component summary | 4–12 | 3 (549) | 0 | MD: 0.51 (−1.26 to 2.29) |
| > 12 | 1 (204) | – | MD: 2.37 (−2.15 to 6.89) | |
| Physical component summary | 4–12 | 3 (549) | 7 | MD: −0.05 (−2.46 to 2.35) |
| > 12 | 1 (204) | – | MD: 0.35 (−5.66 to 6.36) | |
| Diabetes Quality of Life (1–5)† | ≤ 3 | 1 (98) | – | MD: −0.19 (−0.52 to 0.14) |
| 4–12 | 6 (184) | 0 | MD: −0.003 (−0.10 to 0.09) | |
| Diabetes-related worry | ≤ 3 | 2 (166) | 36 | MD: 0.03 (−0.25 to 0.32) |
| 4–12 | 4 (302) | 67 | MD: 0.08 (−0.17 to 0.34) | |
| Impact of diabetes | ≤ 3 | 2 (166) | 59 | MD: −0.01 (−0.31 to 0.28) |
| 4–12 | 4 (302) | 60 | MD: 0.02 (−0.17 to 0.21) | |
| Satisfaction with life | ≤ 3 | 1 (68) | – | MD: 0.24 (−0.05 to 0.53) |
| 4–12 | 4 (222) | 47 | MD: 0.16 (−0.02 to 0.33) | |
| Social/vocational worry | ≤ 3 | 1 (98) | – | MD: −0.12 (−0.33 to 0.09) |
| 4–12 | 3 (249) | 54 | MD: −0.05 (−0.29 to 0.20) | |
| Diabetes Distress Scale (1–6)‡ | 4–12 | 6 (777) | 0 | MD: −0.01 (−0.17 to 0.15) |
| EQ-5D (0–1)† | 4–12 | 2 (743) | 0 | MD: −0.01 (−0.01 to −0.01) |
| PAID (0–100)† | 4–12 | 2 (363) | 0 | MD: 2.86 (1.74 to 3.97) |
| Hypoglycemia (patient-years) | ≤ 3 | 3 (46) | 0 | RR: 0.94 (0.80 to 1.12) |
| 4–12 | 5 (848) | 93 | RR: 0.86 (0.66 to 1.12) | |
| Severe hypoglycemia (patient-years) | 4–12§ | 4 (427) | 92 | RR: 0.59 (0.17 to 2.05) |
| Hypoglycemia (% of patients affected) | ≤ 3 | 5 (462) | 63 | RD, %: 0.0 (−5.5 to 5.5) |
| 4–12 | 4 (282) | 47 | RD, %: 3.1 (−7.9 to 14.2) | |
| Severe hypoglycemia | ≤ 3 | 1 (92) | – | RD, %: 0.0 (−4.2 to 4.2) |
| 4–12 | 10 (1259) | 0 | RD, %: −0.1 (−1.0 to 0.8) | |
Note: CI = confidence interval, EQ-5D = European Quality of Life survey with 5 dimensions, HbA1C = glycated hemoglobin, MD = difference in means, PAID = Problem Areas in Diabetes, RD = difference in risk, RR = risk ratio or rate ratio, SF-12 = 12-item Short Form Health Survey, SF-36 = 36-item Short Form Health Survey, – = not applicable.
*
We used effective sample sizes in cluster trials and patient-years for rate ratios.
†
Large values indicate a better quality of life.
‡
Small values indicate a better quality of life.
§
No data available for time point ≤ 3 mo.