Reminder systems to increase compliance with glucose logging in gestational diabetes: a systematic review and meta-analysis.

Abstract

OBJECTIVE:

We sought to evaluate the effectiveness of reminder systems in improving patient compliance with blood glucose level monitoring in gestational diabetes mellitus in a meta-analysis of randomized controlled trials.

DATA SOURCES:

Scopus, PubMed, CINAHL, and the Cochrane Library were searched from inception to October 2021.

STUDY ELIGIBILITY CRITERIA:

Randomized control trials that examined reminder-based systems (ie, technology assisted or phone based) to prompt pregnant patients with gestational diabetes mellitus to monitor blood glucose levels (compliance) vs traditional management without reminder systems were included. Studies were excluded if they examined only qualitative outcomes or examined patients with preexisting diabetes mellitus or those in which the control group included another intervention rather than standard care.

METHODS:

The primary outcome was patient compliance, defined as the number of blood glucose level values provided by the patient divided by the number of instructed blood glucose level values. The secondary outcomes were maternal mean blood glucose level values, 2-hour glucose tolerance test results after delivery, cesarean delivery rate, neonatal intensive care admission, and rates of large for gestational age or macrosomia. The summary measures were reported as relative risk or mean difference with a 95% confidence interval.

RESULTS:

Overall, 7 randomized controlled trials, including 863 patients, were included in our review. Reminder systems were associated with a statistically significant increase in patient compliance in blood glucose level monitoring (83.5% vs 68.2%; mean difference, 15.87; 95% confidence interval, 10.94-20.80). Reminder systems were associated with a significant decrease in mean blood glucose level values (mean difference, -5.63; 95% confidence interval, -8.10 to -3.15) and in the rate of delivery by cesarean delivery (relative risk, 0.66; 95% confidence interval, 0.49-0.88). Other outcomes, including neonatal intensive care unit admissions, fetal macrosomia, large for gestational age infants, and 2-hour glucose tolerance tests results after delivery were not substantial between the 2 groups.

CONCLUSION:

The use of reminder systems for patients with gestational diabetes mellitus increased patient compliance with blood glucose level monitoring, decreased mean blood glucose level values, and was associated with a decreased risk of cesarean delivery.

• Authors: Rebecca Horgan, Rebecca Pierce-Williams, Gabriele Saccone, Vincenzo Berghella
• Journal: American journal of obstetrics & gynecology MFM (Am J Obstet Gynecol MFM) Vol. 4 Issue 3 Pg. 100586 (05 2022) ISSN: 2589-9333 [Electronic] United States
• PMID: 35124298 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose
• Glucose

Topics

• Blood Glucose (analysis)
• Diabetes, Gestational (diagnosis, epidemiology, therapy)
• Female
• Fetal Macrosomia
• Glucose
• Humans
• Infant, Newborn
• Patient Compliance
• Pregnancy
• Reminder Systems