A Systematic Review of Continuity of Care Strategies for Enhancing Diabetes Self-Management in Older Adults in Asian Countries

Abstract

Background: Diabetes mellitus is a major health challenge among older adults in Asia. Challenges include limited healthcare access and poor self-care adherence. Continuity of care has emerged as a key strategy to enhance diabetes self-management in this population. Purpose: This review aimed to identify the continuity of care strategies in improving diabetes self-management among older adults in Asian countries. Methods: This systematic review was conducted following the PRISMA guidelines and registered on PROSPERO (CRD420251017515). A comprehensive search was performed in five major databases, including CINAHL, PubMed, ScienceDirect, Scopus, and Taylor & Francis. Inclusion criteria covered full-text, english-language experimental studies in Asian countries. Studies were excluded due to lack of full-text access, non-English language, and secondary research. Data analysis was carried out using descriptive qualitative and thematic analysis. Results: A total of 12 included studies were analyzed in this review. Three categories of continuity of care strategies were identified such as social support and educational interventions, community-based interventions and integrated health management, and technology-based interventions and health monitoring. Most of the studies analyzed in this review indicate that continuity of care improves medication adherence, self-efficacy, physical activity, glycemic control, patient satisfaction, and quality of life among older adults with diabetes. For instance, several interventions reported reductions in HbA1c ranging from 0.28% to 0.7%, indicating meaningful clinical improvements in glycemic control among older adults. Conclusion: Continuity of care is an effective strategy for enhancing diabetes self-management among older adults, with a combination of educational, technological, and community-based interventions yielding optimal outcomes. Integrating technology into diabetes monitoring can improve medication adherence, while social support programs and community health services play a vital role in enhancing patients’ overall well-being. This study highlights the need for tailoring continuity of care strategies to the social and cultural contexts of Asian countries to maximize long-term effectiveness.