Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials

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Citation: McDaniel CC, Kavookjian J, & Whitley HP. (2021). Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials. Patient Education and Counseling.

Abstract

OBJECTIVES: The objective of this systematic review was to explore and report the evidence and gaps in the literature for randomized controlled trials (RCTs) studying the effects of motivational interviewing (MI)-based telehealth interventions on outcomes among persons with diabetes (PWD) or prediabetes.

METHODS: Following a modified Cochrane approach, we searched Pubmed, CENTRAL, CINAHL, PsycINFO, and Clinicaltrials.gov. Included studies were RCTs published in English before March 25, 2021 evaluating MI-based telehealth on outcomes for adults with diabetes or prediabetes.

RESULTS: A total of 21 retained articles captured results for 6436 PWD. Among the most commonly investigated outcomes, 60% of articles documented A1C reductions (ranging from<1% to>3%), 56% documented systolic blood pressure reductions, 57% documented diabetes self-efficacy/empowerment improvements, and 40% documented physical activity improvements. Conversely, diastolic blood pressure, lipid panels, body mass index, depressive symptoms, and quality of life were frequently measured outcomes, where MI-based telehealth yielded minor effects (<30% of articles demonstrating improvements).

CONCLUSIONS: MI-based telehealth seems most effective for improving A1C, systolic blood pressure, diabetes self-efficacy, and physical activity behaviors. Variability in outcome assessment and intervention heterogeneity were key challenges impeding comparisons across retained articles.

PRACTICE IMPLICATIONS: MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.

Keywords: Adults (20-59 years), Chronic Diseases, Clinic, Diabetes, Health Care Setting, Home, Narrative review, Phone, Primary health care provider office (e.g., Public health nurse, dietitian, social worker), Seniors (60+ years), Social Support (e.g., counseling, case management, outreach programs)