JMIR Publications

ABSTRACT

Background:

As a result of the novel coronavirus 2019 (COVID-19) pandemic, fewer patients are able to communicate with their health care professionals due to widely encouraged physical distancing. This provides a unique opportunity to evaluate and test the effectiveness of virtual care globally, especially mobile phone facilitated health interventions, called mHealth. This review evaluates how this rapidly growing field of virtual care could be effective in a pandemic situation by using mHealth interventions to manage chronic diseases, in addition to filling gaps within the health care system that have arisen due to COVID-19.

Objective:

To synthesize the published information regarding mobile phone-based virtual care technologies for mHealth interventions implemented in previous pandemics and chronic care. This information can provide an evidence-base to the patient experience and public health virtual care approaches toward COVID-19 control and health services beyond the pandemic.

Methods:

For this rapid review, we included systematic reviews (restricted within the past 2 years), randomized control trials, controlled non-randomized clinical trials, prospective and retrospective cohort studies, and case control studies reporting on mHealth and telehealth technologies on chronic, non-communicable diseases and infectious disease outbreaks and patient centered clinical decision support tools (symptom checkers, chatbots, digital self-triage technologies). PubMed and Cochrane Systematic Libraries were searched for studies dated between 1973 (when the first mobile phone was invented) and August 10, 2020. AMSTAR2 was used to evaluate the quality of systematic reviews.

Results:

Of 4083 potentially relevant records, 130 meeting our inclusion criteria for this review. For virtual care and mHealth technologies managing patient care, the general consensus among systematic reviews was that there is mixed evidence evaluating its efficacy in improving overall health outcomes. Clinical trials assessing adherence to chronic diseases management strategies were the most promising. The inconsistency observed regarding the efficacy of mHealth and virtual care interventions stems from research study bias, dependence on self-reporting, small samples sizes, among many other factors. This noted inconsistency extended to mHealth and virtual care interventions used during pandemics, predominantly focusing on HIV. There have been no evaluations investigating the effectiveness of digitalized case contact tracing during a pandemic or support for isolated individuals and/or health care workers.

Conclusions:

Virtual care technologies could be effective in communicating crucial health care support and advice to patients managing chronic and infectious diseases, as well as individuals in self-isolation. There is no direct evidence regarding the use of virtual care technologies during a respiratory disease-based pandemic; however, reviewing available literature can provide insights into effective virtual care interventions for implementation during a pandemic such as COVID-19. Clinical Trial: N/A