Table 4 Summary of findings for the main comparison

Outcomes

Impact

Relative effect estimate (95% CI)

No. of studies (participants)

Quality of evidence (GRADE)^a

Systolic blood pressure

Follow-up: 6 to 24 months

[28,29,30,31, 33, 35]

SBP MDs ranged from − 8.90 to 3.60 mmHg.One study* [28] was excluded from the meta-analysis due to insufficient data.

MD − 4.26 (− 7.81, − 0.71)

6 (577)

Low¹

Diastolic blood pressure

Follow-up: 12 to 24 months

[30, 31, 33, 35]

DBP MDs − 7.50 to 2.30 mmHg

MD − 2.70 (− 6.19, 0.78)

4 (336)

Low¹

eGFR

Follow-up: 12 to 24 months

[29, 30, 33, 35]

Estimated GFR MDs ranged from -2.60 to 3.50 mL/min/1.73 m². One study* [29] was excluded from the meta-analysis due to insufficient data.

MD 0.59 (− 4.12, 5.29)

4 (499)

Very low^{1, 2, 3}

HbA_1c

Follow-up: 3–24 months

[29, 30, 32,33,34,35]

HbA_1c MDs ranged from − 0.90 to 0.30%.

MD − 0.46% (− 0.83, − 0.09)

6 (595)

Low^{1, 3}

Adherence to medications

Follow-up: 12 months

[35]

One study [35] identified no difference in medication adherence between the control and intervention groups using the Morisky scale.

Not estimable

1 (80)

Moderate⁴

Self-management activity

Follow-up: 3–12 months

[28, 32, 34]

The self-management SMDs for the three studies ranged from 0.31 to 0.99.

SMD 0.56 (0.15, 0.97)

3 (308)

Moderate⁵

Health service utilization

Follow-up: 6–24 months

[28, 30, 32]

Two studies [28, 30] showed no differences in hospitalization between the intervention and control groups and one study [32] reported that the study group had lower hospitalization rates.

Not estimable

3 (389)

Low¹

Health-related quality of life

Follow-up: 3–12 months

[28, 32,33,34]

Two studies [28, 33] showed no difference in quality of life between the intervention and control groups, and in the other two studies [32, 34], the intervention group showed a statistically significant improvement in the quality of life assessment.

SMD − 0.03 (− 0.36, 0.31)

4 (373)

Moderate¹

Death

Follow-up: 12 to 24 months

[30,31,32]

The three studies showed no differences in mortality between the intervention and control groups.

Not estimable

3 (354)

Very low^{1, 6}