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. 2018 Feb 20;18(1):12.
doi: 10.1186/s12911-018-0591-0.

Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review

Jung-Ah Lee  1 , Mona Choi  2 , Sang A Lee  3 , Natalie Jiang  4
Affiliations

Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review

Jung-Ah Lee et al. BMC Med Inform Decis Mak. .

Abstract

Background: Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management.

Methods: Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion.

Results: Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system.

Conclusions: Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

Keywords: Chronic disease management; Disease management; Mobile applications; Mobile health; Self-management.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent to publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram for the systematic review process. The step-by-step process of the application of inclusion and exclusion criteria generated the final number of studies included in the systematic review. †Note: Kristjánsdóttir et al. (2013) was published as part 1 [22] and part 2 [23] with respect to a short-term follow-up and long-term follow-up; thus, the results are based on 12 studies from 13 published articles
Fig. 2
Fig. 2
Risk of bias assessment: Summary graph
Fig. 3
Fig. 3
Risk of bias assessment for individual studies. formula image Low risk of bias; formula image Unclear; formula image High risk of bias
See this image and copyright information in PMC

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