EFFECTIVNESS OF SPECIFIC MOBILE HEALTH APPLICATIONS (mHEALTH-APPS)in GESTATIONAL DIABTETES MELLITUS: A SYSTEMATIC REVIEW (Preprint)

2020 ◽  
Author(s):  
Claudia Eberle ◽  
Maxine Löhnert

BACKGROUND Gestational diabetes mellitus (GDM) emerges worldwide and is closely associated with short- and long-term health issues in women and their offspring, such as pregnancy and birth complications respectively comorbidities, Type 2 Diabetes (T2D), Metabolic Syndrome (MetS) as well as cardiovascular disease (CD). Against this background mobile health applications (mHealth-Apps) do open up new possibilities to improve the management of GDM clearly. OBJECTIVE Since there is – to our knowledge – no systematic literature review published, which focusses on the effectiveness of specific mHealth-Apps on clinical health-related short and long-term outcomes of mother and child, we conducted these much-needed analyses. METHODS Data sources: A systematic literature search in Medline (Pubmed), Cochrane Library, Embase, CINAHL and Web of Science was performed including full text publications since 2008 up to date. An additional manual search in references and Google Scholar was conducted subsequently. Study Eligibility Criteria: Women diagnosed with GDM using specific mHealth-Apps during pregnancy compared to control groups, which met main clinical parameters and outcomes in GDM management as well as maternity and offspring care. Study appraisal and synthesis methods: Study quality was assessed and rated “strong”, “moderate” or “weak” by using the Effective Public Health Practice Project (EPHPP) tool. Study results were strongly categorized by outcomes; an additional qualitative summary was assessed. Study selection: Overall, n= 114 studies were analyzed, n= 46 duplicates were removed, n=5 studies met the eligible criteria and n=1 study was assessed by manual search subsequently. In total, n=6 publications, analyzing n=408 GDM patients in the interventional and n=405 women diagnosed with GDM in the control groups, were included. These studies were divided into n=5 two-arm randomized controlled trials (RCT) and n=1 controlled clinical trial (CCT). RESULTS Distinct improvements in clinical parameters and outcomes, such as fasting blood glucoses (FBG), 2-hour postprandial blood glucoses (PBG), off target blood glucose measurements (OTBG), delivery modes and patient compliance were analyzed in GDM patients using specific mHealth-Apps compared to matched control groups. CONCLUSIONS mHealth-Apps clearly improve clinical outcomes in management of GDM effectively. More studies need to be done more in detail.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Claudia Eberle ◽  
Maxine Loehnert ◽  
Stefanie Stichling

Abstract Background Gestational diabetes mellitus (GDM) emerges worldwide and is closely associated with short- and long-term health issues in women and their offspring, such as pregnancy and birth complications respectively comorbidities, Type 2 Diabetes (T2D), metabolic syndrome as well as cardiovascular diseases. Against this background, mobile health applications (mHealth-Apps) do open up new possibilities to improve the management of GDM. Therefore, we analyzed the clinical effectiveness of specific mHealth-Apps on clinical health-related short and long-term outcomes in mother and child. Methods A systematic literature search in Medline (PubMed), Cochrane Library, Embase, CINAHL and Web of Science Core Collection databases as well as Google Scholar was performed. We selected studies published 2008 to 2020 analyzing women diagnosed with GDM using specific mHealth-Apps. Controlled clinical trials (CCT) and randomized controlled trials (RCT) were included. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Results In total, n = 6 publications (n = 5 RCTs, n = 1 CCT; and n = 4 moderate, n = 2 weak quality), analyzing n = 408 GDM patients in the intervention and n = 405 in the control groups, were included. Compared to control groups, fasting blood glucose, 2-h postprandial blood glucose, off target blood glucose measurements, delivery mode (more vaginal deliveries and fewer (emergency) caesarean sections) and patient compliance showed improving trends. Conclusion mHealth-Apps might improve health-related outcomes, particularly glycemic control, in the management of GDM. Further studies need to be done in more detail.


Author(s):  
Benjamin Patel ◽  
Thomas Edwards ◽  
Timothy Schrire ◽  
Katie Barnard ◽  
Sankhya Sen

Abstract High quality mobile health applications (mhealth apps) have the potential to enhance the prevention, diagnosis and treatment of burns. The primary aim of this study was to evaluate whether the quality of mhealth apps for burns care is being adequately assessed. The secondary aim was to determine whether these apps meet regulatory standards in the UK. We searched AMED, BNI, CINAHL, Cochrane library, Embase, Emcare, Medline and PsychInfo to identify studies assessing mhealth app quality for burns. The PRISMA reporting guideline was adhered to. Two independent reviewers screened abstracts to identify relevant studies. The quality of identified studies was assessed according to the framework proposed by Nouri et al, including design, information/content, usability, functionality, ethical issues, security/privacy and user-perceived value. Of the 28 included studies, none assessed all seven domains of quality. Design was assessed in 4/28 studies; information/content in 26/28 studies; usability in 12/28 studies; functionality in 10/28 studies; ethical issues were never assessed in any studies; security/privacy was not assessed; subjective assessment was made in 9/28 studies. 17/28 studies included apps that met the definition of ‘medical device’ according to MHRA guidance, yet only one app was appropriately certified with the UK Conformity Assessed (UKCA) mark. The quality of mHealth apps for burns are not being adequately assessed. The majority of apps should be considered medical devices according to UK standards, yet only one was appropriately certified. Regulatory bodies should support mhealth app developers, so as to improve quality control whilst simultaneously fostering innovation.


2021 ◽  
Author(s):  
Billy Robinson ◽  
Enying Gong ◽  
Brian Oldenburg ◽  
Katharine See

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


2017 ◽  
Vol 08 (04) ◽  
pp. 1068-1081 ◽  
Author(s):  
Mehrdad Farzandipour ◽  
Ehsan Nabovati ◽  
Reihane Sharif ◽  
Marzieh Arani ◽  
Shima Anvari

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.


Author(s):  
Laura Pradal-Cano ◽  
Carolina Lozano-Ruiz ◽  
José Juan Pereyra-Rodríguez ◽  
Francesc Saigí-Rubió ◽  
Anna Bach-Faig ◽  
...  

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.


2021 ◽  
Author(s):  
Billy Robinson ◽  
Enying Gong ◽  
Brian Oldenburg ◽  
Katharine See

BACKGROUND Asthma is a chronic respiratory disorder which requires long-term pharmacotherapy and patient empowerment 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 asthma mobile applications for the quality and functionality of the apps using a validated tool. None of these reviews have systematically assessed these applications for their content compared to available international best practice guidelines. OBJECTIVE The objective of this study is to conduct a systematic review of adult-targeted asthma mobile health applications. 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 Global Initiative for Asthma (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. A previously developed asthma assessment framework was identified and modified to suit our research and ensure all of these identified recommendations were included. Two popular App stores were then reviewed to identify potential mHealth Apps. These Apps were screened based on pre-defined inclusion and exclusion criteria. Suitable applications were then evaluated. Technical information was obtained from publicly available information. 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. 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 This review represents the first that we know of that will examine all mobile health applications available in Australia targeted to adult asthmatics for their functionality, quality and consistency with international best practice guidelines. Though the review will only be conducted on mHealth Apps available in Australia, many applications are available internationally and thus should be largely generalisable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to adult patients wishing to use mHealth apps as part of their asthma self-management. CLINICALTRIAL PROSPERO 269894


2019 ◽  
Vol 7 (2) ◽  
pp. 81-82
Author(s):  
Johannes Knoch

Background: Mobile health applications are increasingly used in patients with Chronic Obstructive Pulmonary Disease (COPD) to improve their self-management, nonetheless, without firm evidence of their efficacy. This meta-analysis was aimed to assess the efficacy of mobile health applications in supporting self-management as an intervention to reduce hospital admission rates and average days of hospitalization, etc. Methods: PubMed, Web of Science (SCI), Cochrane Library, and Embase were searched for relevant articles published before November 14th, 2017. A total of 6 reports with randomized controlled trials (RCTs) were finally included in this meta-analysis. Results: Patients using mobile phone applications may have a lower risk for hospital admissions than those in the usual care group (risk ratio (RR) = 0.73, 95% CI [0.52, 1.04]). However, there was no significant difference in reducing the average days of hospitalization. Conclusion: Self-management with mobile phone applications could reduce hospital admissions of patients with COPD.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Pei Wu ◽  
Runtong Zhang ◽  
Jing Luan ◽  
Minghao Zhu

Abstract Background Mobile health applications (mHealth apps) have created innovative service channels for patients with chronic diseases. These innovative service channels require physicians to actively use mHealth apps. However, few studies investigate physicians’ participation in mHealth apps. Objective This study aims to empirically explore factors affecting physicians’ usage behaviors of mHealth apps. Based on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) and mHealth apps features, we propose a research model including altruism, cognitive trust, and online ratings. Methods We collected data from physicians who have used mHealth apps and conducted a factor analysis to verify the convergence and discriminative effects. We used a hierarchical regression method to test the path coefficients and statistical significance of our research model. In addition, we adopted bootstrapping approach and further analyzed the mediating effects of behavioral intention between all antecedent variables and physicians’ usage behavior. Finally, we conducted three robustness analyses to test the validity of results and tested the constructs to verify the common method bias. Results Our results support the effects of performance expectancy, effort expectancy, social influence, and altruism on the behavioral intentions of physicians using mHealth apps. Moreover, facilitating conditions and habits positively affect physicians using mHealth apps through the mediating effort of behavioral intention. Physicians’ cognitive trust and online rating have significant effects on their usage behaviors through the mediating efforts of behavioral intention. Conclusions This study contributes to the existing literature on UTAUT2 extension of physicians’ acceptance of mHealth apps by adding altruism, cognitive trust, and online ratings. The results of this study provide a novel perspective in understanding the factors affecting physicians’ usage behaviors on mHealth apps in China and provide such apps’ managers with an insight into the promotion of physicians’ active acceptance and usage behaviors.


2020 ◽  
Vol 4 (s1) ◽  
pp. 53-54
Author(s):  
Avantika Pathak ◽  
Susan Bain ◽  
Eunjoo Pacifici

OBJECTIVES/GOALS: Mobile health applications are widely used by the public but vary in how they are classified and regulated. This study examines the evidence of the safety and efficacy of mobile medical applications specifically focusing on those that are used to manage diabetes. METHODS/STUDY POPULATION: To understand the current regulatory landscape of mobile health applications (mHealth apps) for diabetes, a literature survey was conducted using the Pubmed database. Top mHealth apps were identified by searching the Apple store website using 10 key terms associated with diabetes management applications. A maximum of ten results, when available for each key term, were studied by exploring the FDA databases to understand how the products were regulated and if any were subject to recalls. These selected mHealth apps were also searched on clinicaltrials.gov to see if there were ongoing or completed clinical trials and if the trials were designed to include efficacy and safety outcome measures. RESULTS/ANTICIPATED RESULTS: Of the 71 mHealth apps for diabetes management that were identified, 16 were regulated. These products spanned a diverse range of functions including device data and decision support systems. Although 11 had clinical trial data demonstrating efficacy, only 4 had data demonstrating both efficacy and safety. Two of the regulated applications were subject to product recalls due to programming errors that resulted in incorrect insulin dose recommendations. These two applications had clinical trials evaluating efficacy but not safety. The companies noted that the incorrect insulin calculation from their respective mHealth app could cause either a low- or high-impact hypoglycemic event. DISCUSSION/SIGNIFICANCE OF IMPACT: With little to no clinical trial data to support their safety and efficacy, mHealth apps in the diabetes marketplace pose risks for patients as evidenced by recent safety-related recalls. The results of this study indicate that these products may need to be more tightly regulated.


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