BACKGROUND: Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes.
OBJECTIVE: The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers.
METHODS: A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR.
RESULTS: Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect.
CONCLUSIONS: Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
ANTECEDENTES: La carga mundial de enfermedades crónicas es generalizado y creciente. Este cambio de aguda a la atención crónica requiere un replanteamiento de cómo se invierten los recursos en la gestión de estas condiciones. Una respuesta ha sido la creación de programas e intervenciones que tienen el objetivo de ayudar a los pacientes a manejar mejor sus propias condiciones. Con el tiempo, estas intervenciones y estrategias de autogestión han recurrido cada vez más diversas tecnologías para su aplicación, con la más nueva tecnología de ser teléfonos móviles y servicio de mensajes cortos (SMS).
OBJETIVO: El objetivo de este meta-revisión fue evaluar la evidencia actual sobre el uso de teléfonos móviles y SMS para realizar intervenciones de autogestión de las enfermedades crónicas.
MÉTODOS: Una revisión meta se llevó a cabo de las 11 revisiones sistemáticas (SR) que fueron identificados y recuperados después de una extensa búsqueda en bases de datos electrónicas para los años 2000-2012. La información pertinente se abstrae de cada revisión sistemática y una evaluación de la calidad lleva a cabo utilizando el ("Una herramienta de medición para evaluar Revisiones Sistemáticas") AMSTAR criterios.
RESULTADOS: El número y tipos de estudios incluidos y el número total de sujetos variaron significativamente entre las revisiones sistemáticas. Móvil mensajes de texto de teléfono se informó a mejorar significativamente la adherencia a las citas y la terapia antirretroviral, el fumar a corto plazo las tasas de abandono, y seleccionó los resultados clínicos y de comportamiento. Puntajes AMSTAR oscila entre un 11 a 3, lo que refleja una variación sustancial en la calidad de SR.
VINCULACIÓN DE LAS PRUEBAS A LA ACCIÓN: Los teléfonos móviles y el espectáculo SMS promesa como una tecnología para realizar intervenciones de autogestión para mejorar los resultados de la gestión de la atención crónica. Sin embargo, la calidad de los futuros estudios y revisiones sistemáticas necesita ser mejorado. También hay cuestiones sin resolver acerca de la tecnología en sí.
Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes.
OBJECTIVE:
The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers.
METHODS:
A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR.
RESULTS:
Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect.
CONCLUSIONS:
Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.
