The effectiveness of user-focusedmobile health applications in paediatric chronic disease management: A systematic review

Problem: This systematic review aims to evaluate the effectiveness of user-focused mobile health (mHealth) applications in paediatric chronic disease management. Eligibility criteria: Articles were included under the Population Intervention Comparator Outcome Study (PICOS) design framework for (P) children with a chronic disease, (I) mHealth user-focused apps, (C) usual care/control groups, (O) health outcomes related to chronic diseases, and (S) randomised controlled trials. This study followed the guidelines provided by Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and Mobile Health Evidence Reporting and Assessment. Sample: A comprehensive literature search screening was conducted via CINAHL, PubMed, CENTRAL, ELSEVIER, SAGE, Science Direct, Scopus, Taylor Francis, WoS, and IEEE XPLORE from inception to November 15, 2020. Results: The reviewincluded seven articles, which combined provided data for a total of 755 children. The effects of the mHealth applications on the investigated 31 unique outcomes of five chronic paediatric diseases were mixed, ranging from effective to no effect. The risk of bias in the included studies was mostly either high or concerning according to Risk of Bias tool 2.0. The mobile apps that were evaluated were not standalone apps but were designed to interact with and provide data to healthcare providers. Conclusion: Some mHealth interventions in this systematic review produced clinically meaningful and statistically relevant reductions in health outcomes related to chronic disease management. However, based on the available data, it is not possible to make definitive conclusions concerning the preferred target population of the interventions. Implication: mHealth appsmay be beneficial in improving selected patient outcomes in chronic disease management. Our results may assist the digital health services of hospitals, paediatric nurses who are interested in mHealth, and children who have a chronic disease. (C) 2021 Elsevier Inc. All rights reserved.