Effective Interventions for Homebound Older Adults With Type 2 Diabetes: A Systematic Review

Purpose of ReviewHomebound older adults with type 2 diabetes (T2DM) have worse outcomes compared to older adults with diabetes who are not homebound. This systematic review aimed to summarize evidence on interventions aimed to improve outcomes in homebound older adults with T2DM. The PRISMA guidelines for reporting of systematic reviews were followed. PubMed, CINAHL, SCOPUS, and PsycINFO databases were searched. To be included, studies were published from database inception until November 6, 2023. Eligible studies included Participants who were older adults with a mean age of 60 or older; Interventions of any type; Comparators of any type; Outcomes of hemoglobin A1c (HbA1c), blood pressure, cholesterol, quality of life (QOL), healthcare utilization, depression, anxiety, psychological distress, or mortality; Study designs of clinical trials.Recent FindingsThere were 2,280 articles identified by the search, with nine articles included in the final review. Eight studies were conducted in the United States and one in Japan. Seven used pre-post designs and two were randomized controlled trials. Sample sizes ranged from 11 to 8,318,291. Study participants had a mean age of 60-82 years. Interventions included telehealth, home-based health care with in-home primary care visits, nutrition counseling, and meal delivery programs.SummaryWe found a paucity of studies tailored to homebound older adults with T2DM. Results suggest that interventions provided to homebound older adults with T2DM in the home, including home-based primary care, case management/care coordination, joint patient and caregiver/family education, and home telemonitoring integrated into electronic medical systems, hold promise for improving clinical outcomes.