Hypoglycaemia and brief interventions in the emergency department - A systematic review

Objective: For people with diabetes, severe hypoglycaemia is the most common reason for emergency service usage and emergency department (ED) presentations. Brief interventions (BI) are a recognised intervention strategy in the ED for other conditions but to date, they have not been applied to those with hypoglycemia. This review aims to identify components and outcomes of BI for people with diabetes mellitus to inform the development of BI in the ED. Method: A systematic review of randomized controlled trials was undertaken in MEDLINE, CINAHL, PsychINFO and EMBASE. Studies that examined brief interventions for people with diabetes were considered. Eligible studies were critically appraised and included in a narrative synthesis. Results: A total of 2475 citations were identified, 171 full papers were reviewed and four articles were included for review. The components 'advice' and 'assistance' from the five A Framework were the most frequently used BI components. Statistically significant improvements were achieved in psychological, functional, and satisfaction outcomes. However, clinical outcomes were not improved and economic outcomes like costs of BI were not evaluated. Conclusions: The literature review demonstrated a lack of evidence related to BI in diabetes within the emergency setting despite the ED being an ideal environment. Future research needs to be conducted to investigate the effectiveness of BI for patients with diabetes. (C) 2017 Elsevier Ltd. All rights reserved.