A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension

Abstract

Objective This article reports results from a systematic literature review of the current state of mobile health (mHealth) technologies that have the potential to support self-management for people with diabetes and hypertension. The review aims to (a) characterize mHealth technologies used or described in the mHealth literature and (b) summarize their effects on self-management for people with diabetes and hypertension from the clinical and technical standpoints. Materials and Methods A systematic literature review was conducted following PRISMA guidelines. Online databases were searched in September 2018 to identify eligible studies for review that had been published since 2007, the start of the smartphone era. Data were extracted from included studies based on the PICOS framework. Results Of the 11 studies included for in-depth review, 5 were clinical research examining patient health outcomes and 6 were technology-focused studies examining users’ experiences with mHealth technologies under development. The most frequently used mHealth technology features involved self-management support (n = 11) followed by decision support (n = 6) and shared decision-making (n = 6). Most clinical studies reported benefits associated with mHealth interventions. These included reported improvements in objectively measured patient health outcomes (n = 3) and perceptual or behavioral outcomes (n = 4). Discussion Although most studies reported promising results in terms of the effects of mHealth interventions on patient health outcomes and experience, the strength of evidence was limited by the study designs. Conclusion More randomized clinical trials are needed to examine the promise and limitations of mHealth technologies as assistive tools to facilitate the self-management of highly prevalent comorbidity of chronic conditions, such as diabetes and hypertension.

Health information technology to improve care for people with multiple chronic conditions

“…Finally, care coordination and care planning reviews either did not examine the impact of health IT separately or had limited examples of multimorbidity with their health IT comparisons 36–38 . A self‐management and mobile health IT review focused on the dyad of hypertension and diabetes, finding 11 articles with three reporting improvement in outcomes, all decreases in blood pressure 30 …”

“…Previous literature reviews have synthesized relevant studies of health IT tools (e.g., for self‐management care coordination, or to guide clinical decision making) and, less frequently, multimorbidity (Smith et al, Waschkau et al 29–34 ). None of these review articles directly explored how health IT was meeting the needs of PLWMCC.…”

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

“…Many studies focused on creating and evaluating mobile apps, typically aimed at addressing the needs of patients and consumers. These mobile apps focused on a variety of chronic diseases such as diabetes and hypertension [ 63 , 122 ], cardiovascular health [ 30 , 58 , 121 ], cancer care [ 58 , 127 ], mental health [ 13 , 23 , 25 , 57 , 110 ], seizure management [ 57 ], bladder monitoring [ 56 ], tuberculosis treatment [ 15 ], and parental education [ 40 , 41 ]. A small number of studies focused on telehealth [ 10 , 14 , 140 ] and personal health records or patient portals [ 38 , 109 , 141 ].…”

“…Mobile apps [105,113] [17,29,69,70,81,87,91,99,118,119,126,129,33,130,132,142, 34,36,37,49,50,53,67] [ 10,11,92,96,98,[123][124][125][50][51][52]55,61,66,72,84] [ 13,15,47,54,[56][57][58]63,75,85,108,110,23,[115][116][117]121,122,127,131,[25][26][27]30,35,40,41] Fig. 2 Relative weighting of HF/E outcomes by domain [1].…”

On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

“…A meta‐analysis of 51 randomized controlled trials demonstarted that compared with usual care, mHealth interventions in diabetes and hypertension management yielded significant mean differences in clinical outcomes including blood pressure, fasting blood glucose and HbA1c control and had positive effects on improving quality of life, satisfaction and self‐efficacy. [ 23,24 ] However, until now, these apps are almost exclusively patient‐initiated and not implemented in structured patient care pathways. Therefore, most of the apps remain as lifestyle products and have not found their way to clinical implementation.…”