| 1. 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 |
| -0.87 [-1.47, -0.28] |
Very low |
It may decrease psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
3.0 |
-0.87 [-1.47, -0.28] |
Very low |
| 2. 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 |
| 0.16 [-3.38, 3.69] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
7 |
638 |
0.47 [-4.85, 5.79] |
Low |
8.0 |
-0.09 [-4.82, 4.64] |
Low |
| 3. Weight (management) / Waist size |
| 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 |
| 0.16 [-1.59, 1.92] |
Low |
It may result in little to no difference in waist size (cm) |
4 |
254 |
0.25 [-1.53, 2.03] |
Low |
3.0 |
-3.17 [-14.24, 7.9] |
Low |
| 4. 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 |
| 0.09 [-2.01, 2.18] |
Low |
It likely results in little to no difference in HDL levels (mmol/L) |
4 |
254 |
-0.94 [-4.79, 2.91] |
Moderate |
7.0 |
0.52 [-1.98, 3.01] |
Moderate |
| 5. 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 |
| -5.11 [-9.31, -0.91] |
Moderate |
It likely results in little to no difference in LDL levels (mg/dL) |
5 |
441 |
-4.89 [-10.64, 0.86] |
Moderate |
6.0 |
-5.36 [-11.52, 0.79] |
Moderate |
| 6. 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 |
| 0.1 [-0.23, 0.43] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
3 |
150 |
0.28 [-0.09, 0.64] |
Moderate |
4.0 |
-0.58 [-1.3, 0.15] |
Moderate |
| 7. Adherence / Medication (or other treatment) adherence |
| 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 |
| 1.34 [0.58, 2.1] |
Very low |
It may result in little to no difference in adherence but the evidence is very uncertain |
4 |
762 |
1.59 [0.79, 2.39] |
Very low |
2.0 |
-1.03 [-3.48, 1.42] |
Very low |
| 8. Long-term complications / Long term complications |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -43.61 [-59.53, 48.32] |
Very low |
It may decrease long term complications incidence but the evidence is very uncertain |
1 |
46 |
-0.3726 [-0.9582, 0.213] |
Low |
0.0 |
N/A |
NA |
| 9. 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 |
| -0.68 [-1.81, 0.45] |
Moderate |
It likely results in little to no difference in diastolic blood pressure (mmHg) |
8 |
842 |
-0.47 [-2.05, 1.12] |
Moderate |
7.0 |
-0.91 [-2.53, 0.72] |
Low |
| 10. 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 |
| 0.45 [-1.68, 2.58] |
Very low |
It may result in a large increase in systolic blood pressure levels (mmHg) but the evidence is very uncertain |
8 |
842 |
-0.35 [-3.43, 2.73] |
Low |
7.0 |
1.19 [-1.76, 4.14] |
Low |
| 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 |
| -0.13 [-0.61, 0.36] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
7 |
342 |
0.06 [-0.51, 0.62] |
Low |
4.0 |
-0.62 [-1.54, 0.31] |
Low |
| 12. 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 |
| 0.02 [-1.13, 1.18] |
Low |
It may result in little to no difference in weight (kgs) |
5 |
215 |
0.85 [-0.91, 2.61] |
Low |
6.0 |
-0.6 [-2.13, 0.93] |
Low |
| 13. 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 |
| 0.77 [0.29, 1.25] |
Very Low |
It may increase quality of life but the evidence is very uncertain |
2 |
148 |
0.57 [-0.07, 1.22] |
Very low |
4.0 |
1.03 [0.3, 1.75] |
Low |
| 14. 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 |
| 0.11 [-0.84, 1.06] |
Very low |
It may result in little to no difference in knowledge but the evidence is very uncertain |
1 |
92 |
0.0 [-1.03, 1.02] |
Low |
2.0 |
0.82 [-1.69, 3.32] |
Low |
| 15. 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 |
| -0.27 [-0.43, -0.11] |
Low |
It may result in little to no difference in HbA1C levels (%) |
11 |
1588 |
-0.5 [-0.75, -0.26] |
Low |
11.0 |
-0.09 [-0.31, 0.12] |
Low |
Footnotes per outcome:
1) a) We rated down the certainty of evidence due to very serious risk of bias, serious inconsistency, and 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: 3 comparison(s).The range of follow up was from 2 to 24 months for the studies included in the whole network.
2) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 7 RCT(s) (N=324); Number of comparison(s) informing the indirect estimate: 8 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 1-24 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
3) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=133); Number of comparison(s) informing the indirect estimate: 3 comparison(s). The range of follow up was from 1 to 36 months for the studies included in the whole network. The range of follow-up was 1-24 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 very serious risk of bias
4) a) We rated down the certainty of evidence due to serious risk of bias and serious incoherence; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=133); Number of comparison(s) informing the indirect estimate: 7 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 1-6 months in the studies directly comparing the self-management intervention versus usual care.
5) a) We rated down the certainty of evidence due to serious risk of bias; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=216); Number of comparison(s) informing the indirect estimate: 6 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 1-12 months in the studies directly comparing the self-management intervention versus usual care.
6) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=78); Number of comparison(s) informing the indirect estimate: 4 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 1-6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias
7) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=372); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 1-6 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 and serious inconsistency
8) a) This estimate is a result of a pairwise meta-analysis (1 RCT, N=46); The range of follow-up was 3 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 very serious imprecision
9) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 8 RCT(s) (N=414); Number of comparison(s) informing the indirect estimate: 7 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 1-24 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias
10) a) We rated down the certainty of evidence due to very serious risk of bias and serious incoherence; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 8 RCT(s) (N=414); Number of comparison(s) informing the indirect estimate: 7 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 1-24 months in the studies directly comparing the self-management intervention versus usual care.
11) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 7 RCT(s) (N=174); Number of comparison(s) informing the indirect estimate: 4 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 1-24 months in the studies directly comparing the self-management intervention versus usual care.
12) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=107); Number of comparison(s) informing the indirect estimate: 6 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 3- 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to..
13) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=76); Number of comparison(s) informing the indirect estimate: 4 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 6-6 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
14) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=36); Number of comparison(s) informing the indirect estimate: 2 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 0 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 very serious imprecision
15) a) We rated down the certainty of evidence due to 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: 11 RCT(s) (N=803); Number of comparison(s) informing the indirect estimate: 11 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 3-24 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
2) Ferrer-Garcia-2011, Gram-2010, Grillo Mde-2016, Labrunee-2012, O'Hare-2004, Bellary-2008, Dyson-2010
3) Ferrer-Garcia-2011, Gram-2010, Grillo Mde-2016, Bellary-2008
4) Ferrer-Garcia-2011, Gram-2010, Grillo Mde-2016, Dyson-2010
5) Ferrer-Garcia-2011Gram-2010Grillo Mde-2016Jacobs-2012Labrunee-2012
6) Grillo Mde-2016, Labrunee-2012, Dyson-2010
7) Al-Haj Mohd-2016, Chow-2015, Erku-2017, Negarandeh-2013
8) Sartor-2014
9) Ferrer-Garcia-2011Gram-2010Grillo Mde-2016Jacobs-2012O'Hare-2004Petersen-2013Bellary-2008Dyson-2010
10) Ferrer-Garcia-2011Gram-2010Grillo Mde-2016Jacobs-2012O'Hare-2004Petersen-2013Bellary-2008Dyson-2010
11) Ferrer-Garcia-2011, Gram-2010, Grillo Mde-2016, Labrunee-2012, Petersen-2013, Bellary-2008, Dyson-2010
12) Ferrer-Garcia-2011, Gram-2010, Labrunee-2012, Petersen-2013, Dyson-2010
13) Ferrer-Garcia-2011, Maidana-2016a
14) heinrich-2012
15) Al-Haj Mohd-2016, Chow-2015, Gram-2010, Jacobs-2012, Labrunee-2012, Maidana-2016a, O'Donnell-2016, O'Hare-2004, Santos-2017, Bellary-2008, Dyson-2010
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