Table 1

Inclusion and exclusion criteria for study selection

Screening parameterInclusion criteriaExclusion criteria
Population

  • Adults (≥18 years old) with T2D

  • Any other disease (eg, pre-diabetes, type 1 diabetes and gestational diabetes)

  • Age<18 years old

Exposure

  • Studies that reported a measure of PAct (eg, Patient Activation Measure (PAM) or other PAct measures)

  • Studies that evaluated related constructs such as confidence or self-efficacy

Outcomes

  • Both self-reported and objectively measured outcomes were included

Clinical outcomes

  • HbA1c level/ glycaemic control

  • Systolic blood pressure/diastolic blood pressure

  • Low-density lipoprotein (LDL)/ high-density lipoprotein (HDL)/ total cholesterol

  • Serum triglycerides

  • Body mass index (BMI)/body weight


Self-management behaviours

  • Overall self-management score

  • Outcomes related to diet (e.g. fruit/ vegetable consumption, following a low-fat diet)

  • Outcomes related to physical activity (e.g. step counts, following a regular exercise schedule, frequency of physical activity)

  • Smoking status

  • Outcomes related to alcohol consumption (e.g. alcohol consumption, frequency or amounts)

  • All other outcomes not listed

Study design

  • Original primary research articles

  • All study designs, including cross-sectional, longitudinal and intervention (e.g. RCTs, pre–post comparison studies) were included if they reported the association between PAct and T2D-related outcomes.

Note: For this review, we classified study design based on how it reports the relationship between PAct and T2D-related outcomes. For instance, if an RCT did not report T2D-related outcomes for each intervention group separately and reported pooled temporal associations between PAct and T2D-related outcomes instead, it was treated as a cohort study.
We included intervention studies that report intervention effects on PAct and effects on other specified outcomes but do not directly report on the association of PAct and outcomes if the interventions fulfilled the following criteria:

  • the intervention explicitly targets PAct or is described as enhancing patients’ knowledge, confidence and skills for self-management (as opposed to interventions targeting different related constructs such as self-efficacy); and

  • Increasing PAct is a pivotal, main component of the intervention; and

  • PAct was measured; and

  • the intervention increased PAct scores (PAct measured post-intervention is significantly higher compared with the control group)

  • Study protocols

  • Editorials

  • Literature reviews/meta-analyses

  • Qualitative studies

  • Studies not reporting on empirical data

  • Interventions that did not significantly increase PAct scores (this indicates a shortcoming in its premise or implementation, making it irrelevant to the analysis because it does not contribute to our understanding of how PAct influences T2D-related outcomes).

  • Interventions where PAct components form part of a complex intervention with other components

Comparators

  • For intervention studies, any type of comparator was eligible. This included observational studies or intervention studies with no comparator, e.g. pre–post studies.

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Language and date

  • Only articles in English were included

  • There were no restrictions on publication dates

  • Articles not in English

  • HbA1c, glycated haemoglobin; PAct, patient activation; RCTs, randomised controlled trials; T2D, type 2 diabetes.