Mobile Health Applications and Medication Adherence of Patients With Hypertension: A Systematic Review and Meta-Analysis

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

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The Functionality, Quality and Consistency with International Guidelines of Asthma Mobile Health Applications: Protocol for a Systematic Review. (Preprint)

10.2196/preprints.32617 ◽

2021 ◽

Author(s):

Billy Robinson ◽

Enying Gong ◽

Brian Oldenburg ◽

Katharine See

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Airflow Limitation ◽

Significant Variable ◽

Assessment Framework ◽

Mobile Health Applications ◽

Gina Guidelines ◽

Mhealth Apps ◽

Health Applications

BACKGROUND Asthma is a chronic respiratory disorder defined clinically as a combination of typical respiratory symptoms, and significant variable reversible airflow limitation. In addition to pharmacotherapy, a key aspect of asthma management is empowering patients to manage their condition and recognise and respond to asthma exacerbations. Mobile health applications (mHealth apps) represent a potential medium through which patients could improve the ability to self-manage their asthma. Few studies have conducted a systematic evaluation of both free and paid asthma mobile applications for the quality and functionality of the apps using a validated tool and to our knowledge none have systematically assessed these applications for the quality of information that they provide compared to available international best practice guidelines. This represents the first study that will undertake both of these evaluations for all available mHealth Apps in Australia targeted towards adult asthmatics. The Global Initiative for Asthma (GINA) guidelines represent a regularly updated guideline based on reviews of the available scientific literature by an international panel of experts. This review will examine the functionality and quality of available asthma mobile health applications and the consistency of these available applications with recommendations from the GINA guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications on the Australian market. As part of this review the potential for an mHealth app to improve asthma self-management and the overall quality of the application will be evaluated, using the Mobile App Rating Scale (MARS) framework, and the quality of the information within an app, using the current GINA guidelines as a reference, will be assessed. METHODS A methodological stepwise approach was taken in creating this review. First the most recent GINA guidelines were independently reviewed by two authors to identify key recommendations that could feasibly be incorporated into a mHealth app. These identified recommendations were then compared to a previously developed asthma application assessment framework. A modified assessment framework was created, ensuring all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps and then a screening process based on pre-defined inclusion and exclusion criteria occurred to establish what mHealth Apps would be evaluated. Application evaluation then occurred. Technical information was obtained from publicly available information on the application store or within the app itself. The next step was to perform an application quality assessment using the validated MARS framework to objectively determine the quality of the application. Application functionality was then assessed using the IMS Institute for Health Informatics Functionality Scoring system. Finally, the mHealth applications will be assessed using a checklist that we have developed based on what was identified from the international GINA guidelines. RESULTS To date, funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the applications. Results for this study are expected by the end of this year. CONCLUSIONS Nil as protocol CLINICALTRIAL PROSPERO 269894

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Dot the I’s and Cross the T’s: Comment on “A Systematic Review of Mobile Health Applications in Rehabilitation”

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2018.10.022 ◽

2019 ◽

Vol 100 (4) ◽

pp. 782

Author(s):

Giorgio Ferriero ◽

Francesco Sartorio ◽

Stefano Vercelli

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Mobile Health Applications ◽

Health Applications

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Evaluation of Mobile Health Applications to Track Patient-Reported Outcomes for Oncology Patients: A Systematic Review

Advances in Radiation Oncology ◽

10.1016/j.adro.2020.09.016 ◽

2020 ◽

Author(s):

Diana J. Lu ◽

Mina Girgis ◽

John M. David ◽

Eric M. Chung ◽

Katelyn M. Atkins ◽

...

Keyword(s):

Systematic Review ◽

Mobile Health ◽

Patient Reported Outcomes ◽

Oncology Patients ◽

Patient Reported ◽

Mobile Health Applications ◽

Health Applications

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Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects

Applied Clinical Informatics ◽

10.4338/aci-2017-07-r-0116 ◽

2017 ◽

Vol 08 (04) ◽

pp. 1068-1081 ◽

Cited By ~ 33

Author(s):

Mehrdad Farzandipour ◽

Ehsan Nabovati ◽

Reihane Sharif ◽

Marzieh Arani ◽

Shima Anvari

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Mobile Health ◽

Self Management ◽

Cochrane Central Register ◽

Patient Reported ◽

Mobile Health Applications ◽

Mhealth Apps ◽

Health Applications

Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.

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Using Mobile Applications to Increase Physical Activity: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218238 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8238

Author(s):

Laura Pradal-Cano ◽

Carolina Lozano-Ruiz ◽

José Juan Pereyra-Rodríguez ◽

Francesc Saigí-Rubió ◽

Anna Bach-Faig ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Mobile Health ◽

Mobile Applications ◽

Dietary Behaviour ◽

Cochrane Library ◽

Full Text Review ◽

Mobile Health Applications ◽

Bibliographic Search ◽

Health Applications

Unhealthy diet and physical inactivity—major risk factors for the main non-communicable diseases—can be addressed by mobile health applications. Using an evidence-based systematic review design, we analysed studies on mobile applications to foster physical activity to determine whether they met the objective of increasing adults’ physical activity. A bibliographic search was conducted in October 2020 using PubMed, Cochrane Library Plus, Biomed Central, Psychology Database, and SpringerLink, retrieving 191 articles. After titles and abstracts were reviewed, 149 articles were excluded, leaving 42 articles for a full-text review, of which 14 met the inclusion criteria. Despite differences in study duration, design, and variables, 13 of the 14 studies reported that applications were effective in increasing physical activity and healthy habits as dietary behaviour. However, further longer-term studies with larger samples are needed to confirm the effectiveness of mobile health applications in increasing physical activity.

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Self-management mobile apps for people with epilepsy: A systematic review (Preprint)

10.2196/preprints.22489 ◽

2020 ◽

Author(s):

Mohsen Alzamanan Sr ◽

LIM KHENG SEANG ◽

Maizatul Akmar Ismail ◽

Norjihan Abdul Ghani

Keyword(s):

Medication Adherence ◽

Mobile Health ◽

Mobile Apps ◽

The Self ◽

Self Management ◽

Keywords Epilepsy ◽

Treatment Management ◽

Mobile Health Applications ◽

Patients With Epilepsy ◽

Health Applications

BACKGROUND Patients with epilepsy (PWE) are motivated to manage and cope with their disorder by themselves, that is, self-management (SM). Mobile health applications (apps) have multiple features that show a huge potential to improve self-management of individuals with chronic disorders such as epilepsy. OBJECTIVE This study aims to review all available free apps related to the self-management of PWE and to determine the self-management domains included in these apps METHODS Systematic reviews were performed for all apps by searching in iOS and Android app databases using the keywords “epilepsy” and “seizure.” RESULTS We identified 22 epilepsy SM apps:6 were found in iOS, 7 in Android, and 9 in both.Of the 11 domains of self-management, seizure tracking and seizure response features were available in most Apps(N=22 and N=19respectively), followed by treatment management(N=17) and medication adherence(N=15).Three apps (Epilepsy Journal, Epilepsy Tool Kit and EpiDiary) were installed more than 10,000 times, with features focused specifically on a few domains (including treatment management, medication adherence, health-care communication, and seizure tracking). Two Apps had >6 SM domains (Young epilepsy and E-Epilepsy Inclusion) but both with lower installation rates (5000+ and 100+ respectively). CONCLUSIONS There were mobile health applications to improve self-management in epilepsy in both iOS and Android platform, but the installation rate of most apps was low. The self-management features in various Apps were different and common features included seizure tracking and seizure response.

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