| 1. Physical activity |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.45 [-0.3, 1.2] |
Very low |
It may result in little to no difference in physical activity |
0 |
0 |
[, ] |
NA |
1.0 |
0.45 [-0.3, 1.2] |
Low |
| 2. Quality of life / Psychological distress |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| -0.27 [-1.02, 0.47] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
-0.27 [-1.02, 0.47] |
Low |
| 3. Knowledge |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 1.1 [0.32, 1.87] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
290 |
1.13 [0.16, 2.1] |
Low |
1.0 |
1.04 [-0.25, 2.32] |
Low |
| 4. Lipid profile / LDL-Cholesterol |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.51 [-1.53, 2.56] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
3 |
678 |
0.51 [-1.53, 2.56] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 5. Quality of life |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.31 [-0.28, 0.9] |
Very Low |
It may result in little to no difference in quality of life but the evidence is very uncertain |
1 |
378 |
0.27 [-0.52, 1.05] |
Low |
1.0 |
0.36 [-0.55, 1.27] |
Low |
| 6. Lipid profile / HDL-Cholesterol (mmol) |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 5.17 [2.52, 7.82] |
Low |
It may result in a large decrease in HDL levels (mmol/L) |
3 |
678 |
5.22 [2.46, 7.99] |
Low |
1.0 |
4.51 [-4.84, 13.86] |
Low |
| 7. Lipid profile / Triglycerides |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| -0.08 [-0.39, 0.22] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
3 |
678 |
-0.05 [-0.37, 0.28] |
Low |
1.0 |
-0.46 [-1.45, 0.53] |
Low |
| 8. Lipid profile / Total cholesterol |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 3.35 [-6.28, 12.98] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
2 |
388 |
3.35 [-6.28, 12.98] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 9. Weight (management) / Weight (Kgs/lbs) |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| -0.5 [-2.89, 1.89] |
Low |
It may result in little to no difference in weight (kgs) |
1 |
377 |
-0.5 [-3.68, 2.68] |
Low |
2.0 |
-0.5 [-4.13, 3.13] |
Low |
| 10. Self-management behaviours |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 0.52 [-0.68, 1.72] |
Very low |
It may result in a slight increase in self-management behaviours |
1 |
378 |
0.52 [-0.68, 1.72] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 11. Weight (management) / BMI - Body Mass Index |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| -0.29 [-0.98, 0.4] |
Very low |
It may result in little to no difference in body mass index (kg/m²) but the evidence is very uncertain |
3 |
678 |
-0.18 [-0.97, 0.6] |
Very low |
2.0 |
-0.62 [-2.0, 0.77] |
Very low |
| 12. Blood-pressure / Diastolic pressure |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 1.31 [-1.13, 3.75] |
Very low |
It may result in little to no difference in diastolic blood pressure(mmHg) but the evidence is very uncertain |
3 |
664 |
1.49 [-1.08, 4.06] |
Low |
1.0 |
-0.35 [-8.12, 7.42] |
Low |
| 13. Blood-pressure / Systolic pressure |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| 1.19 [-2.74, 5.13] |
Very low |
It may increase systolic blood pressure levels (mmHg) but the evidence is very uncertain |
3 |
664 |
1.09 [-3.01, 5.19] |
Low |
1.0 |
2.43 [-11.8, 16.66] |
Low |
| 14. HbA1C / Glycated hemoglobin (HbA1c) |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
| -0.51 [-0.81, -0.21] |
Very low |
It may decrease HbA1C levels (%) but the evidence is very uncertain |
4 |
1056 |
-0.45 [-0.82, -0.09] |
Very low |
2.0 |
-0.61 [-1.13, -0.09] |
Very low |
Footnotes per outcome:
1) a) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision; b) Number of studies included in the network: 64 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network.
2) a) We rated down the certainty of evidence due to serious imprecision; b) Number of studies included in the network: 44 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s).The range of follow up was from 2 to 24 months for the studies included in the whole network.
3) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=109); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 2 to 60 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision
4) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=282); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.
5) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=194); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 60 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious imprecision
6) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=282); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.
7) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=282); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias
8) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=173); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias
9) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=193); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 51 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to..
10) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=194); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 1 to 12 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care; b) We rated down the certainty of evidence due to very serious risk of bias, very serious imprecision and serious incoherence
11) a) We rated down the certainty of evidence due to very serious risk of bias and serious inconsistency; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=282); Number of comparison(s) informing the indirect estimate: 2 comparison(s).The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12-12 months in the studies directly comparing the self-management intervention versus usual care.
12) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=278); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision
13) a) We rated down the certainty of evidence due to serious imprecision and very serious risk of bias; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=278); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 12-12 months in the studies directly comparing the self-management intervention versus usual care.
14) a) We rated down the certainty of evidence due to serious imprecision, very serious risk of bias and serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=476); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6-12 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
3) Mohamed-2013
4) Al Lenjawi-2017Johansen-2017Mohamed-2013
5) Jaipakdee-2015
6) Al Lenjawi-2017, Johansen-2017, Mohamed-2013
7) Al Lenjawi-2017, Johansen-2017, Mohamed-2013
8) Al Lenjawi-2017, Johansen-2017
9) Jaipakdee-2015
10) Jaipakdee-2015
11) Al Lenjawi-2017, Johansen-2017, Mohamed-2013
12) Al Lenjawi-2017Johansen-2017Mohamed-2013
13) Al Lenjawi-2017Johansen-2017Mohamed-2013
14) Al Lenjawi-2017, Jaipakdee-2015, Johansen-2017, Mohamed-2013
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