The effectiveness of mobile application for monitoring diabetes mellitus and hypertension in the adult and elderly population: systematic review and meta-analysis.

Emily de Souza Ferreira, Fernanda de Aguiar Franco, Marina Marilac Dos Santos Lara, André Amaral Levcovitz, Mateus Araújo Dias, Tiago Ricardo Moreira, Ary Henrique Morais de Oliveira, Rosângela Minardi Mitre Cotta

Journal: BMC health services research 2023;23(1):855

PMID: 37573312

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Plain Language Summary

Both arterial hypertension (AH) and diabetes mellitus (DM) can be detected in Primary Health Care units in the communities themselves and, with proper monitoring and management and changes in behaviour, it is possible to reduce risk factors that are modifiable to prevent these diseases and to avoid their complications in the long term. The aim of this study was to analyse the effectiveness of mobile applications in health as a digital intervention, to improve the management, self-monitoring and monitoring of adults and elderly people with AH and/or DM This study was a systematic review and meta-analysis of twenty-six articles. Results showed that the use of mobile health applications as a digital intervention improves the management, self-monitoring and monitoring of adult and elderly patients with AH and/or DM and, can be more effective than currently employed strategies. Furthermore, the meta-analysis showed that the intervention group had a reduction of 0.39% in the glycated haemoglobin value (%) compared to the usual care group. Authors concluded their findings indicate mobile applications are used at different levels of care (primary, secondary and tertiary), all with success in clinical and behavioural parameters.

Abstract

CONTEXT

Arterial Hypertension (AH) and Diabetes Mellitus (DM) are diseases that are getting worse all over the world. Linked to this advance, is the growing digital health market with numerous mobile health applications, which aim to help patients and professionals in the proper management of chronic diseases. The aim of this study was to analyze, through a systematic review and meta-analysis, the effectiveness of using mobile health applications in monitoring AH and/or DM in the adult and elderly population.

METHODS

The systematic review and meta-analysis was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Metanalyses guidelines and involved searching five databases - Medline/PubMed, Embase, CINAHL, Virtual Library in Health and Cochrane Library. The review included randomized and cohort clinical trials testing the effects of the intervention on changing biochemical parameters and clinical efficacy in people treated for AH and/or DM. The quality of the selected studies was assessed based on the evaluation criteria of the Joanna Briggs Institute tool. The random effects meta-analysis method was used to explain effect distribution between studies, by Stata® software (version 11.0) and publication bias was examined by visual inspection of graphs and Egger test.

RESULTS

We included 26 studies in the systematic review and 17 in the meta-analysis. These studies were published between 2014 to 2022 in 14 countries. Were reported improvement in knowledge and self-management of AH and DM, social motivation with treatment and behavioral change, reduction in glycated hemoglobin values, fasting glucose and blood pressure, improvement in adherence to drug treatment, among others. The result of the meta-analysis showed that there is evidence that the use of mobile applications can help reduce glycated hemoglobin by 0.39% compared to the usual care group.

CONCLUSIONS

Monitoring and self-monitoring of behaviors and health care related to AH and DM in adults and the elderly through mobile applications, has clinically significant effectiveness in reducing glycated hemoglobin levels. Future studies should provide more evidence and recommendations for best practices and development of digital health interventions.

TRIAL REGISTRATION

PROSPERO. International Prospective Registry of Systematic Reviews. CRD42022361928.

Address: Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Brazil. [email protected].; Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Brazil.; Department of Medicine and Nursing, Federal University Viçosa, Viçosa, Brazil.; Department of Computing, Federal University of Tocantins, Palmas, Brazil.

DOI: 10.1186/s12913-023-09879-6