Effectiveness of self-management interventions for long-term conditions in people experiencing socio-economic deprivation in high-income countries: a systematic review and meta-analysis.
J Public Health (Oxf)
; 45(4): 970-1041, 2023 Nov 29.
Article
in En
| MEDLINE
| ID: mdl-37553102
ABSTRACT
BACKGROUND:
Long-term conditions (LTCs) are prevalent in socio-economically deprived populations. Self-management interventions can improve health outcomes, but socio-economically deprived groups have lower participation in them, with potentially lower effectiveness. This review explored whether self-management interventions delivered to people experiencing socio-economic deprivation improve outcomes.METHODS:
We searched databases up to November 2022 for randomized trials. We screened, extracted data and assessed the quality of these studies using Cochrane Risk of Bias 2 (RoB2). We narratively synthesized all studies and performed a meta-analysis on eligible articles. We assessed the certainty of evidence using GRADE for articles included in the meta-analysis.RESULTS:
The 51 studies included in this review had mixed findings. For the diabetes meta-analysis, there was a statistically significant pooled reduction in haemoglobin A1c (-0.29%). We had moderate certainty in the evidence. Thirty-eight of the study interventions had specific tailoring for socio-economically deprived populations, including adaptions for low literacy and financial incentives. Each intervention had an average of four self-management components.CONCLUSIONS:
Self-management interventions for socio-economically deprived populations show promise, though more evidence is needed. Our review suggests that the number of self-management components may not be important. With the increasing emphasis on self-management, to avoid exacerbating health inequalities, interventions should include tailoring for socio-economically deprived individuals.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Self-Management
Type of study:
Clinical_trials
/
Health_economic_evaluation
/
Systematic_reviews
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limits:
Humans
Language:
En
Journal:
J Public Health (Oxf)
Year:
2023
Document type:
Article
Affiliation country:
Reino Unido