The Impact of mHealth Interventions: Systematic Review of Systematic Reviews

被引:694
作者
Marcolino, Milena Soriano [1 ,2 ]
Queiroz Oliveira, Joao Antonio [1 ,2 ]
D'Agostino, Marcelo [3 ]
Ribeiro, Antonio Luiz [1 ,2 ]
Moreira Alkmim, Maria Beatriz [1 ,2 ]
Novillo-Ortiz, David [3 ]
机构
[1] Univ Fed Minas Gerais, Univ Hosp, Med Sch, Belo Horizonte, MG, Brazil
[2] Univ Fed Minas Gerais, Univ Hosp, Telehlth Ctr, Belo Horizonte, MG, Brazil
[3] Pan Amer Hlth Org, 525 23rd St NW, Washington, DC 20037 USA
关键词
telemedicine; medical informatics; mobile phones; DEVELOPING-COUNTRIES; HEALTH-CARE; NONCOMMUNICABLE DISEASES; MOBILE HEALTH; ATTENDANCE; QUALITY; PHONES;
D O I
10.2196/mhealth.8873
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Mobile phone usage has been rapidly increasing worldwide. mHealth could efficiently deliver high-quality health care, but the evidence supporting its current effectiveness is still mixed. Objective: We performed a systematic review of systematic reviews to assess the impact or effectiveness of mobile health (mHealth) interventions in different health conditions and in the processes of health care service delivery. Methods: We used a common search strategy of five major scientific databases, restricting the search by publication date, language, and parameters in methodology and content. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist. Results: The searches resulted in a total of 10,689 articles. Of these, 23 systematic reviews (371 studies; more than 79,665 patients) were included. Seventeen reviews included studies performed in low- and middle-income countries. The studies used diverse mHealth interventions, most frequently text messaging (short message service, SMS) applied to different purposes (reminder, alert, education, motivation, prevention). Ten reviews were rated as low quality (AMSTAR score 0-4), seven were rated as moderate quality (AMSTAR score 5-8), and six were categorized as high quality (AMSTAR score 9-11). A beneficial impact of mHealth was observed in chronic disease management, showing improvement in symptoms and peak flow variability in asthma patients, reducing hospitalizations and improving forced expiratory volume in 1 second; improving chronic pulmonary diseases symptoms; improving heart failure symptoms, reducing deaths and hospitalization; improving glycemic control in diabetes patients; improving blood pressure in hypertensive patients; and reducing weight in overweight and obese patients. Studies also showed a positive impact of SMS reminders in improving attendance rates, with a similar impact to phone call reminders at reduced cost, and improved adherence to tuberculosis and human immunodeficiency virus therapy in some scenarios, with evidence of decrease of viral load. Conclusions: Although mHealth is growing in popularity, the evidence for efficacy is still limited. In general, the methodological quality of the studies included in the systematic reviews is low. For some fields, its impact is not evident, the results are mixed, or no long-term studies exist. Exceptions include the moderate quality evidence of improvement in asthma patients, attendance rates, and increased smoking abstinence rates. Most studies were performed in high-income countries, implying that mHealth is still at an early stage of development in low-income countries.
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页数:11
相关论文
共 42 条
[1]   Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review [J].
Agarwal, Smisha ;
Perry, Henry B. ;
Long, Lesley-Anne ;
Labrique, Alain B. .
TROPICAL MEDICINE & INTERNATIONAL HEALTH, 2015, 20 (08) :1003-1014
[2]   Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa [J].
Aranda-Jan, Clara B. ;
Mohutsiwa-Dibe, Neo ;
Loukanova, Svetla .
BMC PUBLIC HEALTH, 2014, 14
[3]  
Atkins D, 2004, BMJ-BRIT MED J, V328, P1490
[4]   Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials [J].
Bacigalupo, R. ;
Cudd, P. ;
Littlewood, C. ;
Bissell, P. ;
Hawley, M. S. ;
Woods, H. Buckley .
OBESITY REVIEWS, 2013, 14 (04) :279-291
[5]  
Baron Justine, 2012, J Diabetes Sci Technol, V6, P1185
[6]   Using Mobile Technology for Cardiac Rehabilitation: A Review and Framework for Development and Evaluation [J].
Beatty, Alexis L. ;
Fukuoka, Yoshimi ;
Whooley, Mary A. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2013, 2 (06)
[7]   The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review [J].
Beratarrechea, Andrea ;
Lee, Allison G. ;
Willner, Jonathan M. ;
Jahangir, Eiman ;
Ciapponi, Agustin ;
Rubinstein, Adolfo .
TELEMEDICINE AND E-HEALTH, 2014, 20 (01) :75-82
[8]   Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research [J].
Bloomfield, Gerald S. ;
Vedanthan, Rajesh ;
Vasudevan, Lavanya ;
Kithei, Anne ;
Were, Martin ;
Velazquez, Eric J. .
GLOBALIZATION AND HEALTH, 2014, 10
[9]   Mobile phone messaging reminders for attendance at healthcare appointments [J].
Car, Josip ;
Gurol-Urganci, Ipek ;
de Jongh, Thyra ;
Vodopivec-Jamsek, Vlasta ;
Atun, Rifat .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2012, (07)
[10]   Mobile Phones in Research and Treatment: Ethical Guidelines and Future Directions [J].
Carter, Adrian ;
Liddle, Jacki ;
Hall, Wayne ;
Chenery, Helen .
JMIR MHEALTH AND UHEALTH, 2015, 3 (04) :99-106