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Review
. 2018 May 9:1:12.
doi: 10.1038/s41746-018-0021-9. eCollection 2018.

Prescribable mHealth apps identified from an overview of systematic reviews

Oyungerel Byambasuren  1 , Sharon Sanders  1 , Elaine Beller  1 , Paul Glasziou  1
Affiliations
Review

Prescribable mHealth apps identified from an overview of systematic reviews

Oyungerel Byambasuren et al. NPJ Digit Med. .

Abstract

Mobile health apps aimed towards patients are an emerging field of mHealth. Their potential for improving self-management of chronic conditions is significant. Here, we propose a concept of "prescribable" mHealth apps, defined as apps that are currently available, proven effective, and preferably stand-alone, i.e., that do not require dedicated central servers and continuous monitoring by medical professionals. Our objectives were to conduct an overview of systematic reviews to identify such apps, assess the evidence of their effectiveness, and to determine the gaps and limitations in mHealth app research. We searched four databases from 2008 onwards and the Journal of Medical Internet Research for systematic reviews of randomized controlled trials (RCTs) of stand-alone health apps. We identified 6 systematic reviews including 23 RCTs evaluating 22 available apps that mostly addressed diabetes, mental health and obesity. Most trials were pilots with small sample size and of short duration. Risk of bias of the included reviews and trials was high. Eleven of the 23 trials showed a meaningful effect on health or surrogate outcomes attributable to apps. In conclusion, we identified only a small number of currently available stand-alone apps that have been evaluated in RCTs. The overall low quality of the evidence of effectiveness greatly limits the prescribability of health apps. mHealth apps need to be evaluated by more robust RCTs that report between-group differences before becoming prescribable. Systematic reviews should incorporate sensitivity analysis of trials with high risk of bias to better summarize the evidence, and should adhere to the relevant reporting guideline.

Keywords: Health care; Translational research.

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Conflict of interest statement

Competing interestsThe authors declare no competing financial interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of selection of systematic reviews. *Table of excluded articles due to Inclusion and Exclusion criteria mismatch is provided as Supplementary Information 1. ^Table of excluded articles due to repeated coverage is provided as Supplementary Information 2
Fig. 2
Fig. 2
Scope of the overview
See this image and copyright information in PMC

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