{
  "abstract": "Objectives Continuous Glucose Monitoring (CGM) supports Type 2 Diabetes (T2D) management, but healthcare professionals (HCPs) often face challenges interpreting data. E-learning platforms can enhance knowledge, skills and confidence. This systematic review identified enablers and barriers to e-learning for CGM interpretation.Design Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Data sources PubMed, Ovid MEDLINE, Ovid Embase, Cochrane Library, Scopus, Web of Science and CINAHL were searched on 7 February 2024.Eligibility criteria for selecting studies Studies of HCPs using e-learning for T2D management were included, both comparative and non-comparative. Outcomes included enablers and barriers. Eligible designs were randomised, quasi-experimental, controlled before-and-after and observational studies. No restrictions on setting or language; conference abstracts included if full text was availableData extraction and synthesis Two reviewers independently screened and extracted data using a predefined form; disagreements were resolved by a third reviewer. Thematic analysis identified key enablers and barriers. Methodological quality was assessed using the Downs and Black checklist, and findings were synthesised narratively.Results Four studies met inclusion criteria, including 6790 participants (physicians, nurses, midwives and medical residents). E-learning improved knowledge and skills. Emami et al reported increased knowledge of T2D diagnosis and treatment (p=0.001), while Okuroğlu and Alpar found improvements in diabetes care knowledge and skills (p<0.001). Harris et al noted enhanced self-reported performance (p=0.03) and 84% satisfaction. Enablers included flexibility and accessibility, while barriers involved time constraints, resistance to change and methodological limitations (self-selection bias, lack of blinding). Study quality ranged from fair (three studies) to poor (one study).Conclusion Based on current evidence, it is unclear if e-learning can significantly enhance HCPs’ knowledge, skills and confidence in T2D management. Barriers such as time constraints and resistance to change remain, and the limited number and quality of studies restrict the generalisability of these findings. E-learning may offer potential benefits, but further robust randomised controlled trials are needed to evaluate long-term outcomes and strategies to overcome these challenges.PROSPERO registration number CRD42023455156.",
  "authors": [
    {
      "affiliations": [
        "The University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, New South Wales, Australia",
        "University of Ha’il, College of Nursing, Medical Surgical Nursing Department, Ha’il, Saudi Arabia"
      ],
      "name": "Maha Mouidh Alanazi"
    },
    {
      "affiliations": [
        "The University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, New South Wales, Australia",
        "Equity in Health and Wellbeing Research Program’ at the Hunter Medical Research Institute (HMRI), Newcastle, New South Wales, Australia"
      ],
      "name": "Antoni Fellas"
    },
    {
      "affiliations": [
        "Camurus Pty Ltd, Hyde Park Hub, 223–225 Liverpool Street, Darlinghurst, New South Wales, Australia"
      ],
      "name": "Pascale Bridge"
    },
    {
      "affiliations": [
        "The University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, New South Wales, Australia",
        "Hunter New England Local Health District, John Hunter Hospital, Department of Diabetes and Endocrinology, Newcastle, New South Wales, Australia"
      ],
      "name": "Shamasunder Acharya"
    },
    {
      "affiliations": [
        "Queen Margaret University, School of Health Sciences, Musselburgh, Edinburgh, UK",
        "University of Gibraltar, Gibraltar, Gibraltar"
      ],
      "name": "Derek Santos"
    },
    {
      "affiliations": [
        "The University of Newcastle, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, Newcastle, New South Wales, Australia"
      ],
      "name": "Dean Sculley"
    },
    {
      "affiliations": [
        "Generalitat de Catalunya, Department of Research and Universities, Government of Catalonia, Barcelona, Spain"
      ],
      "name": "Xavier Girones"
    },
    {
      "affiliations": [
        "The University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, New South Wales, Australia",
        "Equity in Health and Wellbeing Research Program’ at the Hunter Medical Research Institute (HMRI), Newcastle, New South Wales, Australia"
      ],
      "name": "Andrea Coda"
    }
  ],
  "title": "Enablers and barriers of e-learning utilising smart technologies in type 2 diabetes care for clinicians: a systematic review",
  "uid": "7b080211-1b0e-53ec-b09b-e16c93ff2b6b"
}