Systematic Review/Meta-analysisResilience in Vulnerable Populations With Type 2 Diabetes Mellitus and Hypertension: A Systematic Review and Meta-analysis
Section snippets
Methods
This review followed the recommended Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.15 The analytic framework of this systematic review is depicted in Fig. 1.
Results
The initial search identified 3574 citations; after abstract and full-text screening, only 17 studies met the eligibility criteria and were included, as shown in Fig. 2.
The risk of bias was moderate to high, mainly because of a lack of clarity of the methodological approach to address blinding, randomization, and selective outcomes reporting, as summarized in Supplemental Appendix S2.
Main findings
In this systematic review, we found diverse and inconsistent evidence regarding the effect of interventions benefiting resilience in diabetes and hypertension management in vulnerable populations. Interventions aimed at enhancing resilience (constructs) significantly improved HbA1c levels in patients with type 2 diabetes when compared with usual care, but there was no comparable effect when compared with other interventions. Discussion groups or workshops were the most common intervention
Acknowledgements
We thank various members of the CRONICAS Centre of Excellence in Chronic Diseases at Universidad Peruana Cayetano Heredia who provided advice throughout different phases of the process, especially Francisco Diez-Canseco. Additionally, our team is extremely grateful to the support provided by Patricia J. Erwin, PLS, and Victor Montori, MD, at the Mayo Clinic, Rochester, Minnesota, USA.
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2021, Exploratory Research in Clinical and Social PharmacyThe Lancet Commission on diabetes: using data to transform diabetes care and patient lives
2020, The LancetCitation Excerpt :In some populations that are vulnerable due to social inequalities or cultural barriers, use of outreach programmes or community-based centres might improve access to care compared with traditional settings based in clinics or hospitals. Similarly, use of trained, non-physician personnel (eg, trained community health workers or peers) to empower and support these individuals and their families to manage stress and solve problems during their day-to-day lives with diabetes might enhance patients' resilience in self-management.426 To translate these efficacy data in trial settings to cost-effectiveness data in real-world practice, policy makers and planners need to develop frameworks in which environment, care settings, providers, processes, supporting systems, and payers are aligned to create impact.427
A qualitative study exploring diabetes resilience among adults with regulated type 2 diabetes mellitus
2020, Diabetes and Metabolic Syndrome: Clinical Research and ReviewsCitation Excerpt :The resilient condition is characterized by better glycemic control levels, good drug management, being able to maintain and control their diet properly as well as being able to carry out routine and controlled activities. Diabetes resilience is a condition related to the ability to survive and rise again from adversity [20,21]. These study results are consistent with previous studies [14,22,23].
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