Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 8, 2024
Date Accepted: Nov 14, 2025
Effectiveness of mHealth Interventions to Improve Follow-up and Management among Solid Organ Transplant Recipients: Systematic Review and Meta-analysis
ABSTRACT
Background:
Effective follow-up and management after organ transplantation are crucial for transplant recipients. MHealth interventions have emerged as a significant approach for facilitating follow-up and management. However, a systematic review and meta-analysis of their effectiveness is lacking.
Objective:
This study aimed to systematically review and synthesize evidence regarding the effectiveness of mHealth interventions in enhancing follow-up and management for transplant recipients.
Methods:
This study included both randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) that compared the effects of mHealth interventions with usual care in transplant recipients by searching PubMed, Web of Science, Scopus, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to June 2025. The primary outcomes included self-care ability, medical regimen adherence, self-monitoring, communication and counseling, medication adherence, physical activity, nutrition, all-cause mortality, complications, re-hospitalization, and emergency and outpatient department visits. The risk of bias for each study was assessed using the Cochrane Risk of Bias tool (RoB 2) for RCTs and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for NRSIs. Data extraction and quality assessment were performed by two reviewers independently. Data synthesis was conducted using Review Manager (version 5.4; Cochrane). Both a meta-analysis and a narrative synthesis were carried out.
Results:
A total of 23 studies (15 RCTs and eight NRSIs) with 2022 transplant recipients were included. Compared to the control group, mHealth interventions significantly improved self-care ability (MD 14.49, 95% CI 9.61 to 19.36, P<.001) and reduced re-hospitalization (OR 0.49, 95% CI 0.34-0.71, P<.001). The meta-analysis demonstrated no statistically significant difference in mortality rates (OR 0.73, 95% CI 0.39-1.35, P=.31), rejection (OR 0.55, 95% CI 0.25-1.19, P=.13)，and infection (OR 0.33, 95% CI 0.06-1.82, P=.20) between the mHealth intervention and control groups. The narrative synthesis indicated that mHealth interventions could effectively promote adherence to medical regimens and medications, facilitate self-monitoring, and improve communication and consultation.
Conclusions:
MHealth interventions significantly improved self-care ability and reduced re-hospitalization rates among organ transplant recipients. However, these interventions did not demonstrate a significant effect on all-cause mortality or complications. MHealth interventions showed potential benefits for various self-management behaviors in organ transplant recipients, but these findings need to be further verified. Future research should prioritize high-quality studies that investigate the impact of mHealth on physical activity, nutrition, and other patient-centered outcomes. Clinical Trial: INPLASY 202480101; https://inplasy.com/inplasy-2024-8-0101/
Citation
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Copyright
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