Unit:
Κατεύθυνση Διεθνής Ιατρική - Διαχείριση Κρίσεων ΥγείαςLibrary of the School of Health Sciences
Author:
Mastorakis Konstantinos
Supervisors info:
Κοντός Μιχαήλ, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Πικουλής Εμμανουήλ, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεωργόπουλος Σωτήριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Innovative Medical Software: Potential & Challenges. A systematic review of studies of mHealth interventions in the management of Diabetes Mellitus in developing countries
Translated title:
Innovative Medical Software: Potential & Challenges. A systematic review of studies of mHealth interventions in the management of Diabetes Mellitus in developing countries.
Summary:
Background: Diabetes mellitus is a major public health problem that is globally widespread, especially in the developing countries. Taking advantage of the exponential growth in mobile phone usage, the lives of those living with the disease can be substantially improved. The aim of this systematic review is the critical appraisal of existing evidence on the effectiveness of mHealth projects in the management of diabetes mellitus in low – and middle – income countries, the main implementation barriers and other contextual factors.
Methods: A literature search of randomized controlled trials of the last decade was performed at MEDLINE and EMBASE databases. English – language articles that quantitatively examined the impact of mHealth interventions over glycaemic control (ΔHbA1c) were included. A plethora of qualitative secondary health outcomes and scientific, practical and financial aspects of the studies that influenced the management of diabetes mellitus were, also, taken into consideration. Risk of bias assessment within articles was conducted with the CONSORT for non – pharmacologic treatments checklist.
Results: Eighteen studies were included in this review (n = 7481 patients – predominantly T2 diabetics –, mean duration = 8,1 months, main location = Asia, major mHealth modality : SMS). Ten trials demonstrated significant improvement on primary outcome by reducing HbA1c value among study groups pre – and post – intervention. Mixed results were yielded for the rest of secondary outcomes (lifestyle change, medication adherence, self-monitoring blood glucose, knowledge and self – efficacy). No effect was observed at the quality of life and the perception/ attitude of the patients. Positive acceptability and utility scores were observed in the intervention recipients.
Discussion: A marginally moderate to higher risk of bias was found. Short duration, small sample sizes, confounding co – interventions/ comparator group care, questionable self – reporting data and heterogeneity of study design and implementation were the most important limitations. Nonetheless, the potential of mHealth interventions on diabetes mellitus lifelong management in undeserved populations was unanimously agreed upon across the studies and remains to be proven by the results of future methodologically robust trials.
Other:
• Funding: None.
• Registration: At the scientific board of the Master’s course.
Main subject category:
Health Sciences
Keywords:
mHealth, Diabetes Mellitus, Developing countries, Mobile health, Glycaemic control, Low and middle income countries
