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An Umbrella Review of Text Message Programs for Adults With Type 2 Diabetes.
Robin Whittemore1, Lauren Siverly1, Dora Lendvai Wischik1
1School of Nursing, Yale University, New Haven, Connecticut.
The Diabetes Educator
|December 23, 2020
Summary
Text message programs effectively improve glycemic control (A1C) and self-management for adults with type 2 diabetes (T2DM). These accessible, inexpensive interventions offer a valuable addition to standard clinical care.
Area of Science:
- Digital Health
- Diabetes Management
- Evidence Synthesis
Background:
- Type 2 diabetes (T2DM) management requires continuous patient engagement.
- Text message interventions offer a scalable and accessible approach to support T2DM self-management.
- Existing systematic reviews provide valuable data on the efficacy of these digital health tools.
Purpose of the Study:
- To synthesize evidence from systematic reviews on text message program effectiveness for T2DM.
- To evaluate impacts on glycemic control (A1C), self-management, and other clinical outcomes.
- To explore the influence of program directionality (unidirectional vs. bidirectional) on outcomes.
Main Methods:
- Umbrella review methodology.
- Systematic search of multiple databases for relevant systematic reviews.
- Inclusion of reviews evaluating text message programs for adults with T2DM and A1C outcomes.
- Quality assessment using AMSTAR-2 and data synthesis.
Main Results:
- Nine systematic reviews (72 studies) indicated text message programs improve A1C (pooled difference -0.38% to -0.8%).
- Improvements were more pronounced in patients with shorter T2DM duration and lower baseline A1C.
- Programs also positively impacted blood pressure, lipids, self-management, and health behaviors, with high satisfaction.
Conclusions:
- Text messaging interventions are effective adjuncts for improving T2DM outcomes.
- These programs are highly accessible, cost-effective, and underutilized in clinical practice.
- Further research may clarify the impact of program directionality and medication engagement.
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