Interventions for family support in cardiometabolic disease: An integrative review.
Angelina P Nguyen, Lan Anh T Mai, Lori A Spies and 1 others
PMID 37212477WHAT IT FOUND
Family support programmes for diabetes and hypertension often improved blood pressure, glucose, weight and self-care, but nagging or resisting change can worsen outcomes.
Ask patients who should support them and what role they want.
Key findings
01Across the reviewed programmes that included family support, 12 studies reported clinical outcomes; more than 90% had at least one improved result, and 66.7% reported statistically significant improvements.
02Three quarters of the studies reporting behavioural outcomes (n = 9) had statistically significant improved outcomes, including medication adherence, blood pressure or glucose monitoring, diet, physical activity, smoking and participation in disease education courses.
03Family involvement was not always helpful: nagging or arguing had a detrimental effect on diabetes self-care, and some family members wanted to keep previous eating patterns.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 16 studies, and the interventions, settings, durations, family roles and outcomes varied widely. Only two studies investigated hypertension, so the evidence is much thinner for hypertension than for type 2 diabetes. Sustainability over time was not well measured; the longest follow-up was at 24 months, likely more than a year after the intervention ended. Reporting bias was noted as a limitation, so positive results may be overrepresented. The review included pilot and mixed-methods studies with poor quality, and family supporters were mostly female spouses or partners, which may not fit all patients or family structures. Because programmes combined education, community support, interdisciplinary teams and technology, the review cannot show how much family involvement alone changed outcomes.
Declared interests
No funding was received, and the authors declared no conflicts of interest.
The easy way to misread this
Do not read this review as proof that simply adding family members to cardiometabolic care improves outcomes. The studies delivered many components at once, including education, behaviour-change support, community workers and mobile health, and some family involvement was null or negative.