The effect of family-based intervention for adults with diabetes on HbA1c and other health-related outcomes: Systematic review and meta-analysis

Aims and objectives To evaluate the effectiveness of family-based intervention for adults with diabetes on glycosylated haemoglobin and other health-related outcomes. Background The impact of family-based intervention on adults with diabetes has been evaluated in various studies, but there is uncertainty about their effect on health-related outcomes for adults with diabetes. Design A systematic review and meta-analysis of randomised controlled trials. Methods A review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Six relevant databases were searched from inception to 5 March 2021. Heterogeneity between studies was quantified by using Higgins' I-2 test. Sensibility and subgroup analyses were used to explore potential heterogeneity. Results The review included 23 studies (3,114 participants). Family-based intervention had a significant effect on improving glycosylated haemoglobin levels, body mass index, blood pressure, fasting glucose, diabetes self-care, diabetes self-efficacy, diabetes distress and positive family support. Non-significant results were obtained for blood lipid, body weight, depression and negative family support. In particular, subgroup analyses indicated that family-based intervention in Asian regions was more effective in improving glycosylated haemoglobin levels than in other areas. Conclusion Family-based intervention may improve diabetes control, diabetes self-care, psychological well-being and positive family support in adults with diabetes and is especially effective in Asian regions. Given the limitations in current studies, further studies are recommended to combine family theory with family-based intervention, and to examine the effectiveness of such intervention for family members. Relevance to clinical practice: This review and meta-analysis provides evidence that family-based intervention can improve positive family support, which has a good effect on diabetes control and psychological well-being in adults with diabetes, and it is especially effective in Asian regions. Findings suggested that unreinforced participation by family members and integrating flexible strategies into family-based intervention may be equally effective.