Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review

Abstract

BackgroundAdherence to chronic disease management is critical to achieving improved health outcomes, quality of life, and cost-effective health care. As the burden of chronic diseases continues to grow globally, so does the impact of non-adherence. Mobile technologies are increasingly being used in health care and public health practice (mHealth) for patient communication, monitoring, and education, and to facilitate adherence to chronic diseases management.ObjectiveWe conducted a systematic review of the literature to evaluate the effectiveness of mHealth in supporting the adherence of patients to chronic diseases management (“mAdherence”), and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among patients and health care providers.MethodsWe searched PubMed, Embase, and EBSCO databases for studies that assessed the role of mAdherence in chronic disease management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 1980 through May 2014. Outcomes of interest included effect of mHealth on patient adherence to chronic diseases management, disease-specific clinical outcomes after intervention, and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among target end-users.ResultsIn all, 107 articles met all inclusion criteria. Short message service was the most commonly used mAdherence tool in 40.2% (43/107) of studies. Usability, feasibility, and acceptability or patient preferences for mAdherence interventions were assessed in 57.9% (62/107) of studies and found to be generally high. A total of 27 studies employed randomized controlled trial (RCT) methods to assess impact on adherence behaviors, and significant improvements were observed in 15 of those studies (56%). Of the 41 RCTs that measured effects on disease-specific clinical outcomes, significant improvements between groups were reported in 16 studies (39%).ConclusionsThere is potential for mHealth tools to better facilitate adherence to chronic disease management, but the evidence supporting its current effectiveness is mixed. Further research should focus on understanding and improving how mHealth tools can overcome specific barriers to adherence.

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives (Preprint)

“…In recent years, many projects and programs have been initiated with the objective to develop new models of service delivery, capitalizing on the potential of telehealth to improve accessibility, quality, continuity, efficiency and integration of health care and services, especially for populations with chronic diseases and those living in rural and remote areas [2,[4][5][6][7][8][9].…”

Does Message-Based Communication Through Mobile Phones for Medication and Treatment Adherence Improve Health Outcomes? A Systematic Review

“…There are many factors that could contribute to the success of the innovations, some being experience of the health care workers providing care to the patients, increased adherence due to other factors like fear of death due to unusual or change of circumstances, media campaigns and the messages being relayed through those mobile devices. Based on their popularity, availability, portability, and technological capacity, mobile phones have enormous potential to impact chronic disease management around the globe [7]. Mobile technologies such as phones and wireless monitoring devices are increasingly being used in health care and public health practice for communication, data collection, patient monitoring, and education, and to facilitate adherence to chronic disease management.…”

Preferences for Health Information Technologies Among US Adults: Analysis of the Health Information National Trends Survey (Preprint)

“…[1] More than half of the adults in the U.S. have at least one chronic condition (e.g., hypertension, coronary heart disease, stroke, diabetes, and cancer). [2,3]Cardiovascular disease (CVD) and diabetes are two common chronic conditions that share common risk factors including: age, genetic factors, obesity, poor nutrition, impaired glucose tolerance and physical inactivity.…”

“…[6,7] The need for continuous monitoring, long term planning and frequent interaction of chronic patients with their providers might be addressed with ongoing technological advancements. [1] Emerging health technologies are increasingly being used in health care for communication, data collection, patient monitoring, education, and to facilitate adherence to chronic disease management. [6,8] It has been suggested that various telehealth technologies can assist in reducing both burden and cost of CVD around the world.…”

“…[6,8] It has been suggested that various telehealth technologies can assist in reducing both burden and cost of CVD around the world. [1,[9][10][11] Various technologies such as remote patient monitoring systems, mobile phone intervention programs, electronic health databases, smartphone apps, instant messaging, video calling and patient portals are just a few of the innovative technology concepts repeatedly used to increase adherence to treatment, disease prevention, and health management programs. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] In addition, health technologies have also been shown to increase adherence to various treatment and motivation for selfmanagement of chronic diseases.…”