Effectiveness of smartphone applications in achieving glycemic control among adult diabetic patients: A meta-analysis

@#<strong>BACKGROUND</strong><p>Diabetes Mellitus Type 2 is a significant global health issue with a high prevalence in the Philippines. Managing this condition effectively is crucial, and digital technologies, particularly smartphone (mHealth) applications, have emerged as a potential tool in diabetes self-management.</p><strong>OBJECTIVE</strong><p>This study evaluated the effectiveness of smartphone (mHealth) application use in achieving glycemic control among adults with Type 2 Diabetes Mellitus, focusing on HbA1c levels and medication adherence.</p><strong>METHOD</strong><p>This systematic review and meta-analysis, adhering to PRISMA guidelines, analyzed randomized controlled trials from databases like PubMed and Embase, comparing interventions using mHealth applications with standard care. The primary measures were HbA1c levels and medication adherence.</p><strong>RESULTS</strong><p>Ten studies involving 20,984 participants were included in the meta-analysis. Using mHealth applications led to an average HbA1c reduction of 0.36%, indicating improved glycemic control. There was considerable heterogeneity (I2 = 91%) because of the clinical and methodological diversity of the included studies. Subgroup analysis showed that the younger and older age groups, shorter and longer T2DM duration, and lower and higher HbA1c baseline benefited from its use. Sensitivity analysis still showed high heterogeneity (95%-97%), reflecting clinical diversity. A narrative analysis of two studies highlighted the utility of mHealth applications in tracking diet, physical activity, and vital stats, aiding medication adherence through reminders and data sharing with healthcare providers.</p><strong>CONCLUSION/RECOMMENDATIONS</strong><p>This systematic review and meta-analysis showed the effectiveness of mHealth application use in achieving glycemic control among adults with Type 2 Diabetes Mellitus by improving HbA1c levels and medication adherence. Integrating mHealth applications as adjuncts in family and community medicine as part of personalized care for managing type 2 diabetes in the Philippines can help achieve glycemic control and medication adherence. Future studies should focus on longitudinal assessments, exploring cultural and linguistic factors in the Filipino context to optimize diabetes care within this specialized medical framework.</p>

Effectiveness of telemedicine programs in achieving blood pressure control among adult hypertensive patients: A meta-analysis

Background@#The healthcare system began transitioning from a traditional clinic-based consult to telemedicine due to the COVID-19 pandemic. This change makes telemedicine a promising tool for managing diseases from the comfort of one’s home.@*Objective@#This study aimed to determine the effectiveness of telemedicine in blood pressure (BP) control and the most effective mode of telemedicine in BP control among hypertensive patients.@*Methods@#This meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search for articles was done using electronic databases (PubMed, MESH, and Clinical key). Identified articles were reviewed independently by two researchers and were statistically analyzed.@*Results@#Eight studies were included in the final analysis. A statistically significant difference between intervention and control groups was observed for both SBP and DBP (estimated SMD of SBP at 0.19 mmHg (p-value 0.003, chi2 =30.52, df =11, CI = -0.31 to -0.06) with substantial heterogeneity at 71%; DBP at −0.15 mm Hg (p<.004; x2=14.19, df =9 95% CI −0.25 to − 0.02) with low heterogeneity at 37%).@*Conclusion@#Telemedicine is an effective means of reducing blood pressure among adult hypertensives. It enables access to individualized continuing care in hard-to-reach areas where patients with comorbidities are the high-risk groups. Future research can be done using the same output measurement and statistical analysis to determine the most effective mode of telemedicine in controlling blood pressure.

Barriers to adherence of maintenance medication intake among hypertensive and diabetic patients seen at the out-patient clinic of the Department of Family Medicine-East Avenue Medical Center

Background@#The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Almost half of patients do not enjoy the full benefits of treatment because of poor adherence. The Universal Health Care Act advocates actively improving the health literacy, of every Filipino, motivating them to strictly adhere to the recommended treatment@*Objective@#This study aimed to determine the barriers to adherence of maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting@*Methods@#A cross sectional study design, using the Morisky Medication Adherence Scale (MMAS-8) consisting of 8 questions, with a Cronbach alpha of 0.83 (Highly reliable). Simple random sampling was used for sampling@*Results@#Out of 90 patients, 54 (60.0%) patients were adherent with their medications, while 36 (40.0%) were non-adherent. Collected social demographic profiles were analyzed to determine the barriers to the medication adherence@*Conclusion@#Forgetfulness, missing medication intake because they feel worse, or because they already feel fine are the identified barriers to adherence to maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting. In this monocentric study, the focus was mainly on patient-related factors contributing to non-adherence. Future researches should assess also the Physician and the Health system related factors

Clinical and demographic profile associated with prevalent complications among newly diagnosed Diabetes Mellitus type 2 patients seen at the Family Medicine Outpatient Department of East Avenue Medical Center from May 2018-April 2019

Background@#Diabetes ranks 8th among the Top 10 causes of mortality in the Philippines. Development of complications add to the burden of the disease. The passage of the Universal Health Care Law ensures all Filipinos access to comprehensive set of quality and preventive services without causing financial hardships@*Objective@#To determine the clinical and demographic profile associated with prevalent complications among newly diagnosed T2DM seen at the outpatient setting of a tertiary DOH hospital@*Methods@#A retrospective/cross – sectional study of newly diagnosed Diabetes Mellitus Type 2 from May 2018 – April 2019 using their charts through random sampling was used. Data were analyzed using descriptive statistics, iIndependent Sample T-test and Fisher’s Exact/Chi-square test for the difference of mean and frequency, respectively, and odds ratio from binary logistic regression for significant predictors of complications@*Results@#Of the 116 newly diagnosed T2DM patients. 88 had complications and 28 patients had no complications. Majority of patients were 60-69 years old (40.52%), with SBP range of 140-150 mmHg (44.83%), FBS of >7.5mmHg (43.97%). Values for BUN and Creatinine between the two groups were significantly different. Most frequent complication was hypertension (54.87%). For every 10-year increase in age, the odds of having complications among newly diagnosed increased by 48%. For every 10 mmHg increase in SBP, the odds of having complications among newly diagnosed also increases by 75%.For every 0.5 mg/dl in FBS, the odds of having complications among newly diagnosed also increased by 91%.For every μmol/L in creatinine, the odds of having complications among newly diagnosed also increased 7.51 times@*Conclusion@#The most frequent complications among newly diagnosed T2DM were hypertension, microvascular, then macrovascular complications. The association between the profile and complication seen among newly diagnosed T2DM using odds ratio revealed predictors such as age, systolic blood pressure, FBS and creatinine.