Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 12, 2023
Open Peer Review Period: Feb 12, 2023 - Apr 9, 2023
Date Accepted: May 25, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People with Chronic Conditions: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Digital health interventions to manage chronic conditions have large potential. However, the benefits and harms are still questioned.
Objective:
This systematic review and meta-analysis investigated the benefits and harms of digital health interventions in promoting physical activity in people with chronic conditions.
Objective:
This systematic review and meta-analysis investigated the benefits and harms of digital health interventions in promoting physical activity in people with chronic conditions.
Methods:
We searched MEDLINE, Embase, CINAHL, and CENTRAL from the inception to Oct. 2021. Eligible RCTs were included if they used a digital component in physical activity promotion in adults with one or more conditions: depression or anxiety, ischemic heart disease or heart failure, chronic obstructive pulmonary disease, knee or hip osteoarthritis, hypertension, or type 2 diabetes. The primary outcomes were objectively measured physical activity and physical function (e.g., walk or step tests). We used a random-effects model (REML) for the meta-analyses and meta-regressions analyses to assess the impact of study-level covariates. The risk of bias was assessed using the Cochrane Risk of Bias 2, and the certainty of the evidence was assessed using GRADE.
Results:
Of 10 967 hits, 99 RCTs were included. Compared to usual care/minimal intervention, digital health interventions increased objectively measured physical activity in the short-term (SMD 0.33, 95% CI 0.22 to 0.43) and long-term (SMD 0.21, 95% CI 0.04 to 0.38), but not physical function (short-term: SMD 0.26, 95% CI -0.07 to 0.59, long-term: SMD 0.35; 95% CI -0.03 to 0.73). Secondary outcomes favored the digital interventions for subjectively measured physical activity and physical function, depression, and health-related quality of life (HRQOL) in the short-term. The risk of non-serious adverse events, but not serious, was higher in the digital interventions in the short-term.
Conclusions:
Digital health interventions improved physical activity across various chronic conditions, while short-term effects on physical function, depression, and HRQOL were observed. Future studies should compare the effects of different digital solutions. Clinical Trial: PROSPERO CRD42020189028.
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.