Home monitoring of haemoglobin A1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability
Home monitoring of haemoglobin A1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability
Aim: In the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A1c (HbA1c) levels. We aim to determine the acceptability of self-collected posted capillary blood samples, and if they produce accurate and reliable HbA1c results.
Methods: We include adult studies comparing capillary blood to venous blood for measuring HbA1c. We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed.
Results: Our search retrieved 3747 records. Following de-duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA1c were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range −0.4 to 1.4 mmol/mol vs. capDBS MD range −4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self-collection kits, 83%–96% of participants reported satisfaction, 87%–99% found it easy and 69%–94% reported they would use it again.
Conclusion: Microtubes/capillary tubes look promising as a method of self-collecting and posting capillary blood samples for the measurement of HbA1c based on the accuracy and reliability findings presented. DBS samples demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.
acceptability of healthcare, capillary tubing, correlation studies, diabetes mellitus, dried blood spot testing, glycated haemoglobin A(1c), validity of results
e15033
Colley, Jack
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Dambha-Miller, Hajira
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Stuart, Beth
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Bartholomew, Jazz
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Benton, Madeleine
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Baykoca, Jeni
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Price, Hermione
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April 2023
Colley, Jack
8bde9a0a-911f-4957-8ecb-acb1f29e4b5e
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Bartholomew, Jazz
69dd7a5e-1256-4533-a80d-156e8fc2d4f3
Benton, Madeleine
fb1fcff9-f864-4153-9258-f75737679876
Baykoca, Jeni
46e55303-b158-45ba-8844-5a17714ccb57
Price, Hermione
2d0a0ee9-39fe-4723-92c9-bacfe2dffc94
Colley, Jack, Dambha-Miller, Hajira, Stuart, Beth, Bartholomew, Jazz, Benton, Madeleine, Baykoca, Jeni and Price, Hermione
(2023)
Home monitoring of haemoglobin A1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability.
Diabetic Medicine, 40 (4), , [e15033].
(doi:10.1111/dme.15033).
Abstract
Aim: In the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A1c (HbA1c) levels. We aim to determine the acceptability of self-collected posted capillary blood samples, and if they produce accurate and reliable HbA1c results.
Methods: We include adult studies comparing capillary blood to venous blood for measuring HbA1c. We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed.
Results: Our search retrieved 3747 records. Following de-duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA1c were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range −0.4 to 1.4 mmol/mol vs. capDBS MD range −4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self-collection kits, 83%–96% of participants reported satisfaction, 87%–99% found it easy and 69%–94% reported they would use it again.
Conclusion: Microtubes/capillary tubes look promising as a method of self-collecting and posting capillary blood samples for the measurement of HbA1c based on the accuracy and reliability findings presented. DBS samples demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.
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Home monitoring of HbA1c in diabetes
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Accepted/In Press date: 23 December 2022
e-pub ahead of print date: 23 December 2022
Published date: April 2023
Additional Information:
Funding Information:
The funder and sponsor are Southern Health NHS Foundation Trust. The leading author is funded by a National Institute for Health and Care Research (NIHR) Wessex Clinical Fellowship award.
Publisher Copyright:
© 2022 Diabetes UK.
Keywords:
acceptability of healthcare, capillary tubing, correlation studies, diabetes mellitus, dried blood spot testing, glycated haemoglobin A(1c), validity of results
Identifiers
Local EPrints ID: 475334
URI: http://eprints.soton.ac.uk/id/eprint/475334
ISSN: 0742-3071
PURE UUID: 0f4d6279-4cca-4059-8cad-a7470b2e4116
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Date deposited: 15 Mar 2023 17:44
Last modified: 18 Mar 2024 03:50
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Contributors
Author:
Jack Colley
Author:
Jazz Bartholomew
Author:
Madeleine Benton
Author:
Jeni Baykoca
Author:
Hermione Price
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