Effects of Community- Based Psychological Interventions on Depressive Symptoms and Blood Glucos e Control for Older Individuals with Type 2 Diabetes: A Systematic Review and Meta- Analysis

국문 초록 (Abstract)

본 연구에서는 노인 당뇨 환자를 대상으로 한 지역사회 기반 심리 중재가 환자들의 우울 증상과 혈당조절에 미치는 효과를 체계적으로 고찰하였다. 국내외 7개의 데이터베이스를 사용하여, 2008년 1월 1일부터 2018년 7월 31일까지 발표된 문헌들을 확인하였다. 선정기준에 따라 다섯 편의 연구가 최종 선정되었으며, 총 대상자는 제2형 당뇨 진단을 받은 지역사회 거주 노인 596명이었다. 메타분석에 선정된 네 편의 연구 모두 행동 교육을 목적으로 프로그램을 구성하였다. 추후에는 표본 크기를 늘려 심리적 중재 프로그램을 시행하는것이 바람직하며 더욱 다양한 지역에서 수행하는 것이 필요함을 확인할 수 있었다.

다국어 초록 (Multilingual Abstract)

Background: To review the effects of community-based psychological interventions on depressive symptoms and blood glucose levels of older individuals with type 2 diabetes (T2D).
Methods: A literature search was conducted using seven electronic databases (CINAHL, EMbase, PubMed, CENTRAL, KoreaMed, KISS, and KMbase). The main search terms were ‘diabetes’, ‘depression’, ‘older adult’, and ‘psychological intervention’. The search was restricted to peer-reviewed RCTs published between January 1, 2008 and July 31, 2018.
Results: Five studies with a total of 596 participants met the inclusion criteria. Four studies that were included in the meta-analysis incorporated some form of behavioral strategies. Depressive symptoms were measured in four of the five studies, and HbA1c was measured in two of the five studies. The pooled SMD for depressive symptoms was −0.13 (95% CI, −0.31, 0.04; p=0.13) and −0.63 (95% CI, −0.98, −0.28; p＜0.001) for HbA1c.
Conclusions: This review highlights the need for additional clinical trials for psychological interventions in older individuals with T2D, especially trials on a larger scale with a wider geographical scope.

목차 (Table of Contents)

• Key messages
• Abstract
• Introduction
• Materials and Methods
• Results
• Discussion
• References

참고문헌 (Reference)

1 Heneghan C, "Why clinical trial outcomes fail to translate into benefits for patients" 18 (18): 122-, 2017

2 Gagliardino JJ, "Type 2 diabetes patients educated by other patients perform at least as well as patients trained by professionals" 29 (29): 152-160, 2013

3 Lamers F, "Treating depression in diabetes patients : does a nurse-administered minimal psychological intervention affect diabetes-specific quality of life and glycaemic control? A randomized controlled trial" 67 (67): 788-799, 2011

4 Bond GE, "The effects of a web-based intervention on psychosocial well-being among adults aged 60 and older with diabetes : a randomized trial" 36 (36): 446-456, 2010

5 Shirinzadeh M, "The effect of community-based programs on diabetes prevention in low-and middle-income countries : a systematic review and meta-analysis" 15 (15): 10-, 2019

6 Ismail K, "Systematic Review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in pateints with type 2 diabetes" 363 (363): 1589-1597, 2004

7 Oei TP, "Specific and nonspecific factors in psychotherapy : A case of cognitive therapy for depression" 16 (16): 83-103, 1996

8 Dalton JE, "Publication bias : the elephant in the review" 123 (123): 812-813, 2016

9 Chapman A, "Psychological interventions for the management of glycemic and psychological outcomes of type 2 diabetes mellitus in China : A systematic review and meta-Analyses of randomized controlled trials" 3 : 252-, 2015

10 Mushtaque A, "Prevalence of depression in patients of type 2 diabetes mellitus : A cross sectional study in a tertiary care centre" 10 (10): 238-241, 2016

11 Taveira TH, "Pharmacist-led group medical appointments for the management of type 2 diabetes with comorbid depression in older adults" 45 (45): 1346-1355, 2011

12 Baksi AK, "Peer advisers compared with specialist health professionals in delivering a training programme on self-management to people with diabetes : a randomized controlled trial" 25 (25): 1076-1082, 2008

13 Higgins JP, "Meta-analysis of continuous outcome data from individual patients" 20 (20): 2219-2241, 2001

14 Higgins JP, "Measuring inconsistency in meta-analyses" 327 (327): 557-560, 2003

15 Mchugh ML, "Interrater reliability : The kappa statistic" 22 (22): 276-282, 2012

16 Bogner HR, "Integrating type 2 diabetes mellitus and depression treatment among African Americans : a randomized controlled pilot trial" 36 (36): 284-292, 2010

17 Hu F., "Globalization of diabetes : the role of diet, lifestyle, and genes" 34 : 1249-1257, 2011

18 Weiss DM, "Effect of behavioral intervention on dilated fundus examination rates in older African American individuals with diabetes mellitus" 133 (133): 2015

19 McAuley L, "Does the inclusion of grey literature influence estimates of intervention effectiveness reported in meta-analyses? The Lancet" 356 (356): 1228-1231, 2000

20 Beverly EA, "Do older adults aged 60-75 years benefit from diabetes behavioral interventions?" 36 (36): 1501-1506, 2013

21 Kirkman MS, "Diabetes in older adults" 35 (35): 2650-2664, 2012

22 de Vries HF, "Diabetes and depression care : a randomized controlled pilot trial" 40 (40): 503-513, 2016

23 Markle-Reid M, "Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity" 66 (66): 263-273, 2018

24 Gould RL, "Cognitive behavioral therapy for depression in older people : a meta-analysis and meta-regression of randomized controlled trials" 60 (60): 1817-1830, 2012

25 "Cochrane Collaboration"

26 Sjostrom L, "Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications" 311 (311): 2297-2304, 2014

27 World Health Organization, "A report on Diabetes" 2016

28 Safren SA, "A randomized controlled trial of cognitive behavioral therapy for adherence and depression(CBT-AD)in patients with uncontrolled type 2 diabetes" 37 (37): 625-633, 2013

29 Glasgow R, "A practical randomized trial to improve diabetes care" 19 (19): 1167-1174, 2004

30 Nowlan JS, "A Comparison of single-session positive reappraisal, cognitive restructuring and supportive counselling for older adults with type 2 Diabetes" 40 (40): 216-229, 2015