| 1. 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 |
| 1.77 [-0.72, 4.25] |
Very low |
It may result in little to no difference in adherence |
0 |
0 |
[, ] |
NA |
1.0 |
1.77 [-0.72, 4.25] |
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 |
| -0.85 [-1.88, 0.18] |
Very low |
It may decrease psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
-0.85 [-1.88, 0.18] |
Low |
| 3. 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 |
| -0.42 [-0.93, 0.09] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
4 |
864 |
-0.17 [-0.72, 0.38] |
Low |
3.0 |
-1.96 [-3.31, -0.6] |
Low |
| 4. Experience of care / Care satisfaction |
| 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 |
| -0.05 [-1.87, 1.77] |
Very low |
It may result in little to no difference in care satisfaction but the evidence is very uncertain |
1 |
119 |
-0.05 [-1.87, 1.77] |
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 |
| 0.89 [0.44, 1.34] |
Very Low |
It may increase quality of life but the evidence is very uncertain |
3 |
768 |
1.1 [0.6, 1.6] |
Very low |
1.0 |
-0.1 [-1.17, 0.97] |
Very low |
| 6. 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 |
| 0.36 [-0.31, 1.03] |
Very low |
It may result in little to no difference in physical activity |
1 |
124 |
0.36 [-0.31, 1.03] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 7. 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 |
| -0.07 [-3.68, 3.54] |
Low |
It may result in little to no difference in waist size (cm) |
1 |
594 |
-0.07 [-3.68, 3.54] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 8. Dietary habits / Consumption of fat |
| 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 |
| -0.18 [-1.6, 1.25] |
Very low |
It may result in little to no difference in fat consumption |
1 |
104 |
-0.18 [-1.6, 1.25] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 9. 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 |
| 0.9 [-0.35, 2.15] |
Low |
It may increase self-management behaviours |
1 |
100 |
0.9 [-0.35, 2.15] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 10. 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 |
| 1.21 [-3.66, 6.09] |
Very low |
It may result in little to no difference in total cholesterol (mg/dL) but the evidence is very uncertain |
5 |
910 |
3.24 [-1.97, 8.46] |
Very low |
2.0 |
-12.77 [-26.45, 0.92] |
Very low |
| 11. 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 |
| 0.22 [-0.07, 0.51] |
Very low |
It may result in little to no difference in triglycerides (mmol/L) but the evidence is very uncertain |
5 |
904 |
0.44 [0.13, 0.75] |
Very low |
3.0 |
-1.19 [-1.98, -0.39] |
Very 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 |
| -0.87 [-1.95, 0.22] |
Low |
It may result in little to no difference in weight (kgs) |
5 |
910 |
-0.72 [-1.85, 0.41] |
Low |
3.0 |
-2.66 [-6.55, 1.22] |
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 |
| -1.36 [-4.7, 1.98] |
Very low |
It may increase systolic blood pressure levels (mmHg) but the evidence is very uncertain |
4 |
864 |
0.15 [-3.62, 3.91] |
Low |
4.0 |
-6.9 [-14.14, 0.33] |
Low |
| 14. 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 |
| -0.34 [-2.01, 1.33] |
Low |
It may result in little to no difference in diastolic blood pressure (mmHg) |
4 |
864 |
0.4 [-1.46, 2.27] |
Low |
4.0 |
-3.41 [-7.19, 0.37] |
Low |
| 15. Dietary habits |
| 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 [-0.06, 1.06] |
Very low |
It may result in little to no difference in dietary habits |
1 |
100 |
0.5 [-0.06, 1.06] |
Low |
0.0 |
N/A |
NA |
| 16. 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 |
| 0.49 [-1.2, 2.19] |
Very low |
It may result in little to no difference in LDL levels (mg/dL) |
4 |
820 |
0.81 [-0.9, 2.53] |
Very low |
2.0 |
-13.82 [-25.29, -2.36] |
Very low |
| 17. 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 |
| -0.4 [-0.63, -0.17] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
8 |
1410 |
-0.32 [-0.59, -0.05] |
Very low |
4.0 |
-0.63 [-1.08, -0.18] |
Very low |
| 18. 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 |
| 1.09 [-0.85, 3.02] |
Very low |
It may decrease HDL levels (mmol/L) but the evidence is very uncertain |
5 |
920 |
0.91 [-1.16, 2.98] |
Very low |
1.0 |
2.25 [-3.08, 7.58] |
Very low |
| 19. 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 |
| 1.09 [0.36, 1.81] |
Very low |
It may increase knowledge but the evidence is very uncertain |
2 |
208 |
1.09 [0.36, 1.81] |
Very low |
0.0 |
NA [NA, NA] |
NA |
| 20. Self-efficacy |
| 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 |
| 0.12 [-0.86, 1.11] |
Very low |
It may result in little to no difference in self-efficacy |
1 |
124 |
0.12 [-0.86, 1.11] |
Low |
0.0 |
NA [NA, NA] |
NA |
Footnotes per outcome:
1) a) Number of studies included in the network: 55 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; b) We rated down the certainty of evidence due to very serious imprecision and serious risk of bias
2) 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: 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) 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: 4 RCT(s) (N=454); Number of comparison(s) informing the indirect estimate: 3 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 3-51 months in the studies directly comparing the self-management intervention versus usual care.
4) a) Number of studies included in the network: 13 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=65); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 3 to 14 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 and serious imprecision
5) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=414); 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 3-60 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, very serious risk of bias, and serious inconsistency
6) 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: 1 RCT(s) (N=65); Number of comparison(s) informing the indirect estimate: 0 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 months in the studies directly comparing the self-management intervention versus usual care.
7) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=322); Number of comparison(s) informing the indirect estimate: 0 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 36 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
8) a) Number of studies included in the network: 14 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=51); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 2 to 24 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
9) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=50); 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 1 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
10) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=478); 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 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 very serious risk of bias and to serious inconsistency
11) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=475); Number of comparison(s) informing the indirect estimate: 3 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- 60 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
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=478); Number of comparison(s) informing the indirect estimate: 3 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- 51 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
13) 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: 4 RCT(s) (N=454); 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 3-51 months in the studies directly comparing the self-management intervention versus usual care.
14) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=454); 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 3-51 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
15) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=50); Number of comparison(s) informing the indirect estimate: 0 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 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
16) 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: 171 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=433); 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 3- 6 months in the studies directly comparing the self-management intervention versus usual care.
17) 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: 8 RCT(s) (N=742); 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 3-51 months in the studies directly comparing the self-management intervention versus usual care.
18) 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: 162 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=488); 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 3- 51 months in the studies directly comparing the self-management intervention versus usual care.
19) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=107); Number of comparison(s) informing the indirect estimate: 0 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 1-60 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, serious inconsistency and serious imprecision
20) a) We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision; b) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=65); Number of comparison(s) informing the indirect estimate: 0 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 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
3) Davies-2008, Kattelmann-2009, Trento-2004, Yuan-2014
4) Braun-2009
5) Borji-2017, Davies-2008, Trento-2004
6) Steed-2005
7) Davies-2008
8) Kattelmann-2009
9) Steed-2005
10) Davies-2008, Kattelmann-2009, Trento-2004, Yong-2015, Yuan-2014
11) Davies-2008, Kattelmann-2009, Trento-2004, Yong-2015, Yuan-2014
12) Davies-2008, Kattelmann-2009, Trento-2004, Yong-2015, Yuan-2014
13) Davies-2008Kattelmann-2009Trento-2004Yuan-2014
14) Davies-2008Kattelmann-2009Trento-2004Yuan-2014
15) Steed-2005
16) Davies-2008Kattelmann-2009Yong-2015Yuan-2014
17) Braun-2009, Davies-2008, Kattelmann-2009, Sadeghian-2016, Steed-2005, Trento-2004, Yong-2015, Yuan-2014
18) Davies-2008, Kattelmann-2009, Trento-2004, Yong-2015, Yuan-2014
19) Steed-2005, Trento-2004
20) Steed-2005
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