Abstract
OBJECTIVE: To assess the effectiveness of community-home patient-centred care (PCC) in the self-management of type 2 diabetes using a systematic evaluation approach. METHODS: This systematic review and meta-analysis adhered to the PRISMA 2020 guideline. The PubMed, Excerpta Medica Database, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese Periodicals Full Text Database, CQVIP Chinese Journals Platform and Wanfang databases were searched between database inception and February 2025, with no language limit, using keywords related to type 2 diabetes, PCC and self-management. References of the included studies were reviewed, and citation tracking was used. Eligible studies were English or Chinese peer-reviewed randomised controlled trials (RCTs) involving patients with type 2 diabetes, with PCC applied in the trial group and routine care in the control group, focusing on self-management outcomes. Two reviewers independently screened and extracted data, resolving disagreements through a third reviewer. The Cochrane risk assessment tool was used to assess study quality, with Review Manager 5.3 software used to analyse data using mean difference (MD) and 95%CI via a random-effects model. Heterogeneity was tested, and sensitivity analysis and funnel plots were also used. RESULTS: A total of 18 RCTs were included, including 6 Chinese and 12 English studies, with 1,893 patients with type 2 diabetes followed up in this study. Following intervention for at least 6 months, compared with routine treatment, PCC reduced fasting blood glucose (FBG) (MD = - 1.27, 95%CI: [- 2.19, - 0.74], I(2) = 34%, fixed-effect model) and 2-hour postprandial blood glucose (2hPG) (MD = - 0.76, 95%CI: [- 1.23,-0.28], I(2) = 81%, random-effects model), but there was no improvement in body mass index (BMI) (MD = - 0.59, 95%CI: [- 1.31, - 0.13], I(2) = 0%, fixed-effect model) or foot care (MD = - 1.51, 95%CI: [- 2.17, - 5.19], I(2) = 94%, random-effects model). After 3 months of intervention, compared with the routine treatment, PCC decreased glycosylated haemoglobin A1c (HbA1c) levels (MD = - 0.60, 95%CI: [- 0.88, - 0.32], I(2) = 81%, random-effects model), but the BMI did not decrease significantly (MD = - 0.26, 95%CI: [- 1.46, - 0.93], I(2) = 0%, fixed-effect model). CONCLUSION: Compared with routine nursing, community-home PCC nursing can reduce the levels of FBG, 2-hour plasma glucose (2hPG) and glycated haemoglobin A1c (HbA1c) in patients with type 2 diabetes. A unified PCC protocol could help patients with diabetes control the disease.