The effectiveness of family interventions in people with diabetes mellitus: a systematic review

Aims To conduct a systematic review of reports of published literature to assess which family interventions are effective in improving diabetes-related outcomes in people with diabetes and family members (blood or non-blood relatives) residing in their homes., Methods We searched computerized bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, WOS, ERIC, Cochrane, CDP, and SocAbs) for randomized clinical trials published in any language that evaluated the effectiveness of family-based interventions with no age restriction. Only studies focused on interventions in young populations (< 18 years) and involving a parent were combined in a meta-analysis for glycated haemoglobin (GHb) using DerSimonian and Laird random effects model. Effect sizes for knowledge outcomes were estimated using the Cohen's d (standardized mean differences) formula. Results Our searches identified 19 randomized controlled trials. Positive effect sizes of family interventions on knowledge for five studies (N = 217) were demonstrated {0.94 [95% confidence interval (CI) 0.67,1.82]). A beneficial effect of interventions on GHb for eight studies (N = 505) was also observed using meta-analysis [-0.6 (95% CI-1.2,-0.1)]. Conclusions Evidence suggests that family interventions in family or household members of people with diabetes may be effective in improving diabetes-related knowledge and glycaemic control.