JMIR Publications

ABSTRACT

Background:

Diabetes self-management education and support (DSMES) is a key element in the care of all patients with diabetes. Mobile health (mHealth) tools are widely used for diabetes self‑management. To improve the completeness of reporting on mobile health (mHealth) interventions, the World Health Organization's Mobile Health Technology Evidence Review Group developed the mERA (Mobile Health Evidence Reporting and Assessment) checklist. However, the uneven quality of research reports has become a major bottleneck, hindering the synthesis of evidence and impeding the translation of research findings into practical applications.

Objective:

We aims to use the mERA checklist as an evaluation tool to analyze the reporting quality of published RCTs of mobile health interventions for adult diabetes. By statistically analyzing the item compliance rate, identify the weak points in the current research reports and analyze how key defects affect the research's feasibility, scalability, and sustainability. Based on the above analysis, propose targeted management strategies to address the identified issues.

Methods:

We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to review articles on mHealth interventions for adults with diabetes. We systematically searched PubMed, Embase, Web of Science, MEDLINE, and the Cochrane Library to identify relevant studies available from the inception of each database up to December 1, 2024.

Results:

Among the 3,486 studies identified through database searches, 120 studies that met the eligibility criteria were analyzed. Most studies used mobile apps(54.2%) as the intervention. Of the 120 included studies, 60.0% required participants to have digital literacy or device ownership. Reporting was assessed with the mERA core checklist. Technology platform and intervention delivery were commonly reported (80.0% and 86.7%), whereas interoperability (7.50%), data security (16.67%), compliance with guidelines (18.33%), and intervention fidelity (26.67%) were rarely reported. Few studies detailed cost assessment (15.00%) or programme training (40.00%). These gaps constrain evaluation of feasibility, scalability and sustainability.

Conclusions:

Overall, this study outlines the current state of empirical research reports on mHealth interventions for adults with diabetes. We describe structural flaws that undermine the transparency, reproducibility, and scalability of evidence. This study identifies four key gaps affecting the translation of evidence on mHealth interventions for adults with diabetes—system integration, safety and compliance, user engagement, and equity. Based on these findings, we propose a set of action frameworks for authors, reviewers, and funders.