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Home visits by healthcare providers help diabetic patients manage their condition

Han L, Ma Y, Wei S, et al.  Are home visits an effective method for diabetes management? A quantitative systematic review and meta-analysis Journal of Diabetes Investigation. 2017 March.

Review question

• Do home visits by healthcare providers help in help patients manage their diabetes?

Background

• The number of people with diabetes is steadily increasing because of poorer diets, less active lifestyles and an aging population.
• The economic cost of diabetes is high and steadily rising as existing approaches to treatment have failed to help control it (for instance, through better disease-management programs in primary-care settings). 
• Home visits by healthcare providers, such as nurses, have shown promising results in diabetes management and may provide a way to control the growing cost of diabetes on the healthcare system.

How the review was done

• A detailed search of seven electronic databases for studies published up until 2016 was conducted. Studies that focused on a variety of diabetes-related outcomes, such as blood sugar levels, in diabetic patients receiving home visits were included.
• A total of 295 articles were identified in searches, and seven studies were included in the review after assessments for eligibility.
• The review was funded by the National Nature Science Foundation of China and the Fundamental Research Funds for the Central Universities.

What the researchers found

• The review found that home visits by healthcare providers improved a number of outcomes in diabetic patients as compared to usual care, including blood sugar, quality of life, some cholesterol levels, blood pressure, and self-management.
• There was no noticeable improvement in long-term outcomes such as body weight and total cholesterol levels, which may result from included studies generally having short follow-up.
• Future research looking at cost-effectiveness is important in determining whether home visits can be a useful tool in combating the growing challenges of diabetes management for millions of people.

Conclusion

• This review found that home visits can be an effective tool in diabetes management, primarily by reducing blood sugar levels in diabetic patients. To determine whether home visits can be used on a large, population-wide scale, cost-effectiveness studies are necessary.