Supervisors info:
Νανάς Σεραφείμ, Ομότιμος Καθηγητής, Ιατρική Σχολή ΕΚΠΑ
Ρούτση Χριστίνα, Καθηγήτρια, Ιατρική Σχολή ΕΚΠΑ
Λεβεντάκης Νικόλαος, Υποψήφιος Διδάκτωρ, Ιατρική Σχολή ΕΚΠΑ
Summary:
Background: Worldwide, 454.6 million people suffer from chronic respiratory diseases, with 3.97 million losing their lives to non-communicable respiratory diseases in 2019 alone. Disability caused by these diseases is marked by symptoms such as breathlessness, fatigue, anxiety, depression, and fear. Pulmonary rehabilitation has demonstrated benefits in improving exercise capacity, muscle strength, functional ability, and quality of life in individuals with chronic respiratory diseases. While reducing symptoms, hospitalizations, and healthcare visits, it also enhances disease self-management and self-efficacy. Despite its significant benefits, the effects of PR tend to wane gradually 6 to 12 months post-completion. Barriers to participation in PR programs include limited program availability, especially in rural areas, transportation difficulties, lack of healthcare professionals, and inadequate patient knowledge about the benefits of PR. mHealth technologies can address some of these issues by allowing patients to participate from home at their convenience. They provide symptom tracking, educational materials, and communication with specialists and fellow patients.
Objective: This systematic review aims to evaluate the effectiveness of mHealth technologies in improving self-management in PR for patients with chronic respiratory diseases and assess their impact on clinical outcomes such as quality of life, pulmonary function and exercise capacity.
Methods: In February 2024, a search was conducted in the online libraries PubMed and PEDro for articles from 2019 onwards using keywords and Boolean operators: ((mobile Health) OR (mobile apps) OR smartphone OR mhealth) AND (pulmonary rehabilitation) AND self-management. Inclusion criteria were articles focusing on mHealth applications in the self-management of chronic respiratory diseases, while exclusion criteria included interventions via mobile phone, such as calls or text messages, and studies on cardiac rehabilitation.
Results: A total of 16 studies met the inclusion criteria and were included in the review. Of these, 12 focused on COPD, 3 on Asthma, and 1 on CF They exhibited variability in terms of design, population, and types of mHealth interventions. Findings, although inconsistent across studies regarding the effectiveness of the technologies, suggest potential for mHealth interventions to improve self-management behavior and treatment adherence among patients with chronic respiratory diseases. They may positively impact quality of life and exercise capacity, reduce exacerbation frequency, and limit healthcare service utilization.
Conclusion: Findings indicate that mHealth technologies hold great potential in supporting pulmonary rehabilitation and self-management programs for chronic respiratory diseases. Furthermore, they have shown promising results in terms of improved disease control, reduced exacerbations, and enhanced patients’ quality of life. There is a need for the design of personalized therapy plans tailored to the needs of each patient. Further research and larger-scale studies are required for a comprehensive understanding of the long-term impact and effectiveness of mHealth interventions in pulmonary rehabilitation. Continuous monitoring of technological advancements is necessary to identify tools that will make interventions more effective.
Keywords:
M-Health, Mobile-health, Self-management, Pulmonary rehabilitation, Pulmonary disease, Chronic respiratory diseases
