Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 6, 2019
Date Accepted: May 4, 2020
Date Submitted to PubMed: Aug 19, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of health apps to improve patient outcomes in the self-management of type 2 diabetes and/or hypertension: A systematic review and meta-analysis of randomized controlled trials
ABSTRACT
Background:
Health apps have emerged as promising tools to improve patient self-care.
Objective:
A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of health apps on patient outcomes in the self-management of type 2 diabetes and/or hypertension.
Methods:
Medline, Cochrane Library, Embase, and CINAHL Plus were searched for RCTs published between January 2007 and January 2019 evaluating health apps developed for the self-management of type 2 diabetes and/or hypertension. Data were analyzed using meta-analysis and a narrative synthesis.
Results:
Twenty-six RCT studies, representing 27 individual trials, were identified and analyzed. Eleven outcomes were meta-analyzed, and the results showed that health apps use was associated with significant reductions in HbA1c (standard mean difference (SMD) -0.42, [95% confidence interval (CI), -0.57 to -0.27], p < 0.001), fasting blood glucose (SMD = -0.29, [95% CI, -0.49 to -0.10], p = 0.004), systolic blood pressure (SMD = -0.17, [95% CI, -0.31 to -0.03], p = 0.02), diastolic blood pressure (SMD = -0.17, [95% CI, -0.30 to -0.03], p = 0.02), and waist circumference (SMD = -0.23, [95% CI, -0.43 to -0.04], p = 0.02). No significant differences in body weight, body mass index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were observed between the intervention and control groups. Thirty-nine outcomes were narratively synthesized. The results of narrative synthesis indicated that only a few of the trials reported positive effects of health apps on these outcomes.
Conclusions:
The findings suggested that health apps use appears to be effective in improving some of the patient outcomes, most likely because their use offers advantages in managing health-related data remotely, providing personalized self-care suggestions, facilitating communication between patients and their healthcare providers, and supporting improved decision-making. Health apps have significant potential. RCTs with longer study period are required to further investigate long-term clinical effects of such technologies.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.