Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews

• Published in: PloS one Vol. 12; no. 3; p. e0173160
• Main Authors: Kitsiou, Spyros, Paré, Guy, Jaana, Mirou, Gerber, Ben
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-03-2017; Public Library of Science (PLoS)
• Subjects: Analysis; Applications programs; Biology and life sciences; Care and treatment; Cellular telephones; Chronic illnesses; Communication; Computer and Information Sciences; Consolidation; Decision making; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Diabetes Mellitus - diagnosis; Diabetes Mellitus - therapy; Education; Electronic devices; Engineering and Technology; Glucose; Health care; Hemoglobin; Humans; Information systems; Internet; Literature reviews; Management; Medical care; Medicine and Health Sciences; Meta-analysis; Meta-Analysis as Topic; Mobile Applications; Mobile computing; Patients; Portable computers; Quality; Quality assessment; Research and Analysis Methods; Researchers; Self care (Health); Smartphone; Smartphones; Systematic review; Telemedicine; Telemedicine - methods; Telemedicine - standards; Text messaging; Type 2 diabetes; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0173160

Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes.
The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers.
A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR.
Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect.
Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.