A Systematic Review of mHealth Effectiveness on Improving Health Outcome of Diabetic Patients

A systematic Review of mHealth Effectiveness on Improving
Health Outcome of Diabetic Patients
ABSTRACT
BACKGROUND
Diabetes is a major disease which affects many people globally which leads to increase
morbidity and increased mortality and huge consumption of health care utilization . It is
projected that increase in diabetes prevalence and costs are likely to be observed. Studies
undertaken have revealed that self management on diabetes and support improve
hemoglobin levels, thus reducing the risks of developing complicated conditions. Thus
offering optimal care for diabetes patients proves o be a challenge. Often patients
experience challenges in accessing and adhering to health care services due to poor
understanding of self care and poor patient provider information sharing.
Various technologies have emerged including tablets, cell phones, smart phones and
other hand held devices, offering new opportunities which could be leveraged, thus
addressing challenges on remote monitoring and clinical guidance delivery. The shift
towards leveraging this platform has increased in the recent past. Evidences and
systematic reviews thus are geared towards assessing this kind of evidence and
determine their levels. This systematic reviews gears towards addressing and appraising
medicines collected from meta analysis on the usefulness and effectiveness of mHealth
intervention in addressing this challenges in diabetic care.
• Population: the diabetic patients suffering from diabetes and ending health care
services
• Intervention: intervention will be utilization of mHealth solution
• Comparison: compared to the strict or other interventions
• Outcome: Improved diabetic care management
The PICO question will be: What are the effectiveness of mHealth solutions in
addressing health care needs of diabetic patients attending health care services
compared to non usage of any mHealth interventions?
OBJECTIVES
• The purpose of this review is to critically offer an appraisal of evidenced from various
systematic reviews on mHealth effectiveness
• To consolidate evidences focusing on the effectives of Mhealth interventions in
providing diabetic patients towards improving health care outcomes.
METHODS
• The study obtained the research evidence using MEDLINE, CINAHL, Embase and
Cochrane databases. This search using the PICOT question obtained the systematic
reviews done, filtered between the years of 2010-2018. further the searchers were
implemented using various techniques through the use of Boolean operators; AND
and OR. Key terms searched included, ‘mHealth on Diabetes’, ‘Technology on Diabetic
pataints’, ‘Telehealth on Diabetic patients. Further other heading terms such as
diabetes mellitus, telemedicine and cellular phone were utilized.
RESULTS
• Of all the studies obtained from the searches done, 6 reported on the effects of
mHealth focussing on diabetes interventions, (Baron et al, 2012, Cole-Lewis.2010).
• Review undertaken by Jongh et al, (2012), focussed on the effects of mobile phone
application on health care.
• Strong evidences was established between mobile phone usage through transmission
of clinical feedback improved diabetic patients glycaemia control, (Buhi et al., 2013).
• Effectiveness of mHealth interventions was found to be positive on diabetes and
improvements of glycaemia index, (deJongh et al, 2012, Free et al., 2013, Cole
Lewis,2010)
DISCUSSIONS
CONCLUSIONS
• Previous studies undertaken have shown that mhealth interventions are often made with
theoretical background and behavioural models. Findings reveal that there is insufficient
level of evidences which are adaptive and effective than others, (Cole-Lewis, 2010)
• Few studies provide theoretical background. Thus future studies need to embedded on
reporting and utilization of theories of change. Further , factors associated with
behaviour of change needs to be addressed.
• The noted lack of theoretical basis for mHealth, could improve on effectiveness of
mHealth interventions.
Diabetes is a chronic diseases which ahs huge impacts on health care.
various mobile based technologies have been rolled out to offer
mHealth solutions. This innovative approaches aim at improving self
management care. the objective of this Picots review is to appraise
and consolidate evidence which offers effectiveness of mHealth
solutions for diabetic patients. A comprehensive search was
undertaken on the databases and filtered to between 2010 and 2018.
the results showed that 5 studies were eligible for inclusion. The
results showed an average of mHealth interventions improving
glycemic control compared to those which were non health
approaches. Findings of the study were consistent with clinical
improvements especially type 2 diabetes.
• Availability of high level of evidence of on the systematic reviews showed an average
usage of mobile based applications having clinical feedback towards improvement of
glycemic control.
• Intervention which combined text messaging and internet functionalities and internet
self help were effective..
• Studies having daily frequency of intervention and interactive sessions reported
improved health outcomes.
REFERENCES
Baron, J., McBain, H., & Newman, S. 2012. The impact of mobile monitoring technologies on glycosylated hemoglobin in
diabetes: a systematic review. Journal of diabetes science and technology, 6(5), 1185-1196.
Buhi, E. R., Trudnak, T. E., Martinasek, M. P., Oberne, A. B., Fuhrmann, H. J., & McDermott, R. J. 2013. Mobile phone-based
behavioural interventions for health: A systematic review. Health Education Journal, 72(5), 564-583.
Cole-Lewis, H., & Kershaw, T. 2010. Text messaging as a tool for behavior change in disease prevention and management.
Epidemiologic reviews, 32(1), 56-69.
De Jongh, T., Gurol-Urganci, I., Vodopivec-Jamsek, V., Car, J., & Atun, R. 2012. Mobile phone messaging for facilitating self-
management of long-term illnesses. Cochrane Database Syst Rev, 12, CD007459.
Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., ... & Haines, A. 2013. The effectiveness of mobile-health
technology-based health behaviour change or disease management interventions for health care consumers: a systematic
review. PLoS medicine, 10(1), e1001362.