Nurse-Led Tele-Coaching on Modifiable Cardiovascular Risk Factors in People with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Background: Tele-coaching has been used by nurses as one of the accessible and sustainable interventions for individuals with type 2 diabetes mellitus. However, evidence has been lacking to demonstrate its effectiveness in mitigating the related cardiovascular risk factors.

Aims: To systematically evaluate the effectiveness of nurse-led tele-coaching on the modifiable cardiovascular risk factors (glycated hemoglobin, blood pressure, & lipid levels) among individuals with type 2 diabetes mellitus.

Methods: A systematic search of eight databases (Cochrane Library, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, PsycINFO, Web of Science, & ProQuest Dissertations and Theses) was conducted for randomized controlled trials of nurse-led tele-coaching for individuals with type 2 diabetes mellitus published in English up to October 30, 2018. A meta-analysis was conducted for the primary outcomes of the studies.

Results: Twelve randomized controlled trials were selected that included 3,030 participants. Results from the meta-analysis revealed statistically significant reductions for not only glycated hemoglobin (pooled mean difference = -1.23, 95% CI: -1.63 to -0.8, I² = 0%, p < .00) but also systolic blood pressure (SBP; pooled mean difference = -2.22, 95% CI: -3.95 to -0.49, I² = 0%, p < .01); such findings are supportive of the use of nurse-led tele-coaching on the primary outcome.

Linking evidence to action: Results from the meta-analyses have shown that nurse-led tele-coaching is an effective and accessible intervention that could improve the glycemic control and SBP among individuals with type 2 diabetes mellitus.