Multifaceted interventions to enhance patient's adherence to self-monitoring blood glucose: A systematic review.

Abstract

Routine Self-Monitoring of Blood Glucose (SMBG) is essential for achieving glycemic targets and hence reducing diabetes-related complications. However, patient's adherence to SMBG remains suboptimal worldwide. This systematic review aims to identify interventions that enhance SMBG adherence among patients with diabetes mellitus. An extensive search of relevant literature was conducted using two databases (Scopus and Web of Science (WoS)) to identify the significant studies. Only English-language articles published between 2015 and 2024 were included in this review. Quality assessment was performed using the Critical Appraisal Skills Program (CASP) and Joanna Briggs Institute (JBI) Critical Appraisal Checklist. A narrative analysis approach was employed, utilizing the Social-Ecological Model (SEM) as the analytical framework for data interpretation. A total of 24 articles resulted in a total of 38 interventions were included in the review. The interventions addressed four levels of SEM: intrapersonal (i.e., education and digital health tools to enhance knowledge and skills), interpersonal (i.e., family involvement and guidance by healthcare workers), community (i.e., involvement of community health workers and support group) and policy (i.e., reward or incentives for SMBG). Among the 38 interventions, 27 were implemented at multiple levels and exhibited improvement in SMBG frequency among the patients. A suitable approach is needed to strengthen SMBG empowerment among patients with diabetes. These findings highlighted that interventions that targeted multiple levels of SEM are more likely to promote SMBG adherence among patients with diabetes and ultimately lead to better health outcomes.