Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 2, 2018
Open Peer Review Period: Oct 6, 2018 - Nov 11, 2018
Date Accepted: Dec 9, 2018
(closed for review but you can still tweet)
Towards developing a standardized core set of outcome measures in mHealth interventions for tuberculosis management: A systematic review
ABSTRACT
Background:
Tuberculosis (TB) management can be challenging in low- and middle- income countries (LMICs) not only due to its high burden, but also the prolonged treatment period involving multiple drugs. With the rapid development in mobile technology, mHealth (Mobile Health) or using mobile device for TB has gained popularity. Despite the potential usefulness of mHealth for TB, few studies have quantitatively synthesized evidence on its effectiveness, presumably due to variability in outcome measures reported in the literature.
Objective:
The aim of this systematic review was to evaluate the outcome measures reported in TB mHealth literature in LMICs
Methods:
MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched to identify mHealth intervention studies for TB (published up to May 2018) which reported any type of outcome measures. Extracted information included the study setting, types of mHealth technology used, target population, study design, and categories of outcome measures. Outcomes were classified into 13 categories including treatment outcome, adherence, process measure, perception, technical outcome, and so on. The qualitative synthesis of evidence focused on the categories of outcome measures reported by type of mHealth interventions.
Results:
A total of 27 studies were included for the qualitative synthesis of evidence. The study designs varied widely, ranging from randomized controlled trials (RCTs) to economic evaluations. Most studies adopted short message service (SMS), while others used SMS in combination with additional technologies or mobile applications. The study population was also diverse including TB patients, TB/HIV patients, healthcare workers and general patients attending a clinic. There was a wide range of variations in the definition of outcome measures across the studies. Amongst the diverse categories of outcome measures, treatment outcomes have been reported in most of the studies, but only a few studies measured the outcome according to the standard TB treatment definitions by the World Health Organization.
Conclusions:
This critical evaluation of outcomes reported in mHealth studies for TB management suggests that substantial variability exists in reporting the outcome measures. To overcome challenges in evidence synthesis for mHealth interventions, this study can provide insights into the development of a core sets of outcome measures by intervention type and study design.
Citation

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