Digital Health Interventions for Cardiometabolic Health Outcomes in Rural and Remote Australia: A Systematic Review.
Cheru Tesema Leshargie, Meless Gebrie Bore, Hazel Dalton and 9 others
PMID 41451959WHAT IT FOUND
In rural and remote Australia, digital diabetes care lowered HbA1c in some studies, a telestroke study reported reduced mortality, but weight results were mixed and engagement gaps persisted.
Key findings
01An included telemonitoring program for type 2 diabetes in Townsville, which used home blood glucose and blood pressure monitoring plus support from a diabetes care coordinator, reported HbA1c reduction from 8.4% to 7.5% (p=0.004), while the control group showed no change (8.1%). The paper does not separate the contribution of monitoring devices and coordinator support.
02An included Telestroke program in regional and rural South Australia, which used secure video consultations, multimodal CT perfusion imaging and comprehensive stroke management plans, reported reduced mortality at 6 months (HR=0.53, 95% CI: 0.41-0.69, p<0.001) and 12 months (HR=0.58, 95% CI: 0.44-0.76, p<0.001). The paper does not separate the contribution of each component.
03An included obesity program in Newcastle that used a smartphone app, Fitbit tracking and calorie-counting tools found no significant weight changes at six or twelve months (p>0.05). The paper does not separate the contribution of each component.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not combine studies statistically because interventions, populations, follow-up times and outcomes varied too much. The included trials were not uniformly strong: among seven randomised controlled trials, one was high risk, five had some concerns and one was low risk. The quasi-experimental study had serious risk of bias, and observational, mixed-method and qualitative studies ranged from high quality to low to moderate quality. Most included studies were from Queensland and New South Wales, so results may not apply across all remote Australian settings. The search was limited to peer-reviewed literature, so unpublished or locally reported rural digital health work may have been missed. The supplied text does not state the total number of participants across the 17 included studies. Several interventions showed no significant change or only short-term effects, so positive results were not consistent across conditions.
Declared interests
Funded by a Commonwealth of Australia grant from the Department of Health. The funder had no role in the design, search strategy, study selection, data extraction, quality appraisal, data synthesis, interpretation, reporting, manuscript preparation, review or approval, or decision to submit. The authors declared no conflicts of interest. AI was used only to edit grammar, clarity and readability, and not in study design, extraction, analysis, interpretation or conclusion development.
The easy way to misread this
Do not read this as proof that digital health interventions improve cardiometabolic outcomes. The review could not combine studies statistically, several included studies had risk of bias, and some interventions showed no significant change or only short-term effects.