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

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.

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


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


Author(s):  
Murtaja Ali Saare ◽  
Azham Hussain ◽  
Wong Seng Yue

This article examines the link between the older adult’s cognitive decline, and Assistive Mobile Health Applications in terms of quality of life as researcher has found scarcity in explaining the mediating role of assistive mobile health applications towards the quality of life of older adults with cognitive decline. Researchers have identified the importance of using assistive mobile health applications in connection of the older adult’s cognitive decline. However, it remained unaddressed in the explaining the mediating role of assistive mobile health application. Therefore, this paper aims to provide an insight that the adoption of assistive m-health applications will provide this population with potential solution to their challenging aging life, hence, enhancing their quality of life. In addition, this paper is only a conceptual explanation, as it aims to identify the possible reasons that influence their Smartphone adoption. Factors were identified using a systematic literature review on relevant peer reviewed papers. The study summarized the empirical evidences which were used to support the conceptual explanation. It is expected that this work will lead towards the empirical findings on the explanation of the mediating role of the assistive mobile health applications to address the relationship of older adult’s cognitive decline and quality of life. This paper providesdirections for future studies in improving the quality of life of older adults.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025714 ◽  
Author(s):  
Benard Ayaka Bene ◽  
Siobhan O’Connor ◽  
Nikolaos Mastellos ◽  
Azeem Majeed ◽  
Kayode Philip Fadahunsi ◽  
...  

IntroductionThe emergence of mobile health (mHealth) solutions, particularly mHealth applications (apps), has shown promise in self-management of chronic diseases including type 2 diabetes mellitus (T2DM). While majority of the previous systematic reviews have focused on the effectiveness of mHealth apps in improving treatment outcomes in patients with T2DM, there is a need to also understand how mHealth apps influence self-management of T2DM. This is crucial to ensure improvement in the design and use of mHealth apps for T2DM. This protocol describes how a systematic review will be conducted to determine in which way(s) mHealth apps might impact on self-management of T2DM.MethodsThe following electronic databases will be searched from inception to April 2019: PubMed, MEDLINE, EMBASE, Global Health, PsycINFO, CINAHL, The Cochrane Central Register of Controlled Trials, Scopus, Web of Science, ProQuest Dissertations & Theses Global, Health Management Information Consortium database, Google Scholar and ClinicalTrials.gov. The Cochrane risk of bias tool will be used to assess methodological quality. The primary outcome measures to be assessed will be ‘change in blood glucose’. The secondary outcomes measures will be ‘changes in cardiovascular risk markers’ (including blood pressure, body mass index and blood lipids), and self-management practices. Others will include: health-related quality of life, economic data, social support, harms (eg, death or complications leading to hospital admissions or emergency unit attendances), death from any cause, anxiety or depression and adverse events (eg, hypoglycaemic episodes).Ethics and disseminationThis study will not involve the collection of primary data and will not require ethical approval. The review will be published in a peer-reviewed journal and a one-page summary of the findings will be shared with relevant organisations. Presentation of findings will be made at appropriate conferences.Trial registration numberCRD42017071106.


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.


EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1567-1578
Author(s):  
Deirdre A Lane ◽  
Naoimh McMahon ◽  
Josephine Gibson ◽  
Jo C Weldon ◽  
Michal M Farkowski ◽  
...  

Abstract Aims A plethora of mobile health applications (m-health apps) to support healthcare are available for both patients and healthcare professionals (HCPs) but content and quality vary considerably and few have undergone formal assessment. The aim is to systematically review the literature on m-health apps for managing atrial fibrillation (AF) that examine the impact on knowledge of AF, patient and HCP behaviour, patients’ quality-of-life, and user engagement. Methods and results MEDLINE, EMBASE, CINAHL, and PsychInfo were searched from 1 January 2005 to 5 September 2019, with hand-searching of clinical trial registers and grey literature. Studies were eligible for inclusion if they reported changes in any of the following: (i) knowledge of AF; (ii) provider behaviour (e.g. guideline adherence); (iii) patient behaviour (e.g. medication adherence); (iv) patient quality-of-life; and (v) user engagement. Two reviewers independently assessed articles for eligibility. A narrative review was undertaken as included studies varied widely in their design, interventions, comparators, and outcomes. Seven studies were included; six m-health apps aimed at patients and one at HCPs. Mobile health apps ranged widely in design, features, and method of delivery. Four studies reported patient knowledge of AF; three demonstrated significant knowledge improvement post-intervention or compared to usual care. One study reported greater HCP adherence to oral anticoagulation guidelines after m-health app implementation. Two studies reported on patient medication adherence and quality-of-life; both showed improved quality-of-life post-intervention but only one observed increased adherence. Regarding user engagement, five studies reported patient perspectives on usability, three on acceptability, and one on feasibility; overall all m-health apps were rated positively. Conclusion Mobile health apps demonstrate improvements in patient knowledge, behaviour, and quality of life. Studies formally evaluating the impact of m-health on HCP behaviour are scarce and larger-scale studies with representative patient cohorts, appropriate comparators, and longer-term assessment of the impact of m-health apps are warranted.


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 19 (1) ◽  
Author(s):  
Miss Charlotte L. Moss ◽  
Ajay Aggarwal ◽  
Asad Qureshi ◽  
Benjamin Taylor ◽  
Teresa Guerrero-Urbano ◽  
...  

Abstract Background Patient reported outcome measurements (PROMs) are emerging as an important component of patient management in the cancer setting, providing broad perspectives on patients’ quality of life and experience. The use of PROMs is, however, generally limited to the context of randomised control trials, as healthcare services are challenged to sustain high quality of care whilst facing increasing demand and financial shortfalls. We performed a systematic review of the literature to identify any oncological benefit of using PROMs and investigate the wider impact on patient experience, in cancers of the pelvic abdominal cavity specifically. Methods A systematic review of the literature was conducted using MEDLINE (Pubmed) and Ovid Gateway (Embase and Ovid) until April 2020. Studies investigating the oncological outcomes of PROMs were deemed suitable for inclusion. Results A total of 21 studies were included from 2167 screened articles. Various domains of quality of life (QoL) were identified as potential prognosticators for oncologic outcomes in cancers of the pelvic abdominal cavity, independent of other clinicopathological features of disease: 3 studies identified global QoL as a prognostic factor, 6 studies identified physical and role functioning, and 2 studies highlighted fatigue. In addition to improved outcomes, a number of included studies also reported that the use of PROMs enhanced both patient-clinician communication and patient satisfaction with care in the clinical setting. Conclusions This review highlights the necessity of routine collection of PROMs within the pelvic abdominal cancer setting to improve patient quality of life and outcomes.


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