Clinical and patient-centered implementation outcomes of mHealth interventions for type 2 diabetes in low-and-middle income countries: a systematic review
- PMID: 34991593
- PMCID: PMC8734304
- DOI: 10.1186/s12966-021-01238-0
Clinical and patient-centered implementation outcomes of mHealth interventions for type 2 diabetes in low-and-middle income countries: a systematic review
Abstract
Background: The prevalence of Type 2 Diabetes is rising in Low- and Middle-Income Countries (LMICs), affecting all age categories and resulting in huge socioeconomic implications. Mobile health (mHealth) is a potential high-impact approach to improve clinical and patient-centered outcomes despite the barriers of cost, language, literacy, and internet connectivity. Therefore, it is valuable to examine the clinical and implementation outcomes of mHealth interventions for Type 2 Diabetes in LMICs.
Methods: The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines were applied in framing and reporting the review criteria. A systematic search of Cochrane Library, Web of Science, PubMed, Scopus, and Ovid databases was performed through a combination of search terms. Randomized Controlled Trials (RCTs) and cohort studies published in English between January 2010 and August 2021 were included. Risk of bias for missing results in the included studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Quantitative and qualitative methods were used to synthesize the results.
Results: The search identified a total of 1161 articles. Thirty studies from 14 LMICs met the eligibility criteria. On clinical outcomes, 12 and 9 studies reported on glycated hemoglobin (HbA1c )and fasting blood glucose (FBG) respectively. Text messages was the most commonly applied mHealth approach, used in 19 out of the 30 studies. Ten out of the 12 studies (83.3%) that reported on HbA1c had a percentage difference of <0.3% between the mHealth intervention and the comparison group. Additionally, studies with longer intervention periods had higher effect size and percentage difference on HbA1c (1.52 to 2.92%). Patient-centred implementation outcomes were reported variedly, where feasibility was reported in all studies. Acceptability was reported in nine studies, appropriateness in six studies and cost in four studies. mHealth evidence reporting and assessment (mERA) guidelines were not applied in all the studies in this review. CONCLUSION: mHealth interventions in LMICs are associated with clinically significant effectiveness on HbA1 but have low effectiveness on FBG. The application of mERA guidelines may standardize reporting of patient-centered implementation outcomes in LMICs.
Trial registration: PROSPERO: Registration ID 154209.
Keywords: clinical outcomes; mHealth; patient-centered implementation outcomes; type 2 diabetes mellitus.
© 2022. The Author(s).
Conflict of interest statement
The authors declare that they have no competing interests.
Similar articles
-
Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217. Cochrane Database Syst Rev. 2022. PMID: 36321557 Free PMC article.
-
Mobile health interventions for HIV/STI prevention among youth in low- and middle-income countries (LMICs): a systematic review of studies reporting implementation outcomes.Implement Sci Commun. 2021 Nov 6;2(1):126. doi: 10.1186/s43058-021-00230-w. Implement Sci Commun. 2021. PMID: 34742357 Free PMC article. Review.
-
Effectiveness of mHealth Interventions for Improving Contraceptive Use in Low- and Middle-Income Countries: A Systematic Review.Glob Health Sci Pract. 2020 Dec 23;8(4):813-826. doi: 10.9745/GHSP-D-20-00069. Print 2020 Dec 23. Glob Health Sci Pract. 2020. PMID: 33361244 Free PMC article. Review.
-
Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia.Med J Aust. 2020 Dec;213 Suppl 11:S3-S32.e1. doi: 10.5694/mja2.50881. Med J Aust. 2020. PMID: 33314144
-
mHealth Application Areas and Technology Combinations*. A Comparison of Literature from High and Low/Middle Income Countries.Methods Inf Med. 2017 Aug 8;56(7):e105-e122. doi: 10.3414/ME17-05-0003. Methods Inf Med. 2017. PMID: 28925418 Free PMC article.
Cited by
-
Is Web-Based Program Effective on Self-Care Behaviors and Glycated Hemoglobin in Patients with Type 2 Diabetes: A Randomized Controlled Trial.Iran J Nurs Midwifery Res. 2023 Nov 9;28(6):723-729. doi: 10.4103/ijnmr.ijnmr_59_22. eCollection 2023 Nov-Dec. Iran J Nurs Midwifery Res. 2023. PMID: 38205411 Free PMC article.
-
Designing Mobile Phone Text Messages Using the Behavior Change Wheel Framework to Influence Food Literacy in Adults With Type 2 Diabetes in Kenya: Protocol for a Systematic Development Study.JMIR Res Protoc. 2023 Dec 4;12:e48271. doi: 10.2196/48271. JMIR Res Protoc. 2023. PMID: 38048150 Free PMC article.
-
Advocacy for patients with headache disorders.eNeurologicalSci. 2023 May 10;31:100466. doi: 10.1016/j.ensci.2023.100466. eCollection 2023 Jun. eNeurologicalSci. 2023. PMID: 37250108 Free PMC article. Review.
-
Cross Sectional and Case-Control Study to Assess Time Trend, Gender Differences and Factors Associated with Physical Activity among Adults with Diabetes: Analysis of the European Health Interview Surveys for Spain (2014 & 2020).J Clin Med. 2023 Mar 22;12(6):2443. doi: 10.3390/jcm12062443. J Clin Med. 2023. PMID: 36983443 Free PMC article.
-
Development and Exploration of the Effectiveness and Feasibility of a Digital Intervention for Type 2 Diabetes Mellitus (DEsireD): Protocol for a Clinical Nonrandomized Pilot Trial in Brunei Darussalam.JMIR Res Protoc. 2022 Dec 7;11(12):e43208. doi: 10.2196/43208. JMIR Res Protoc. 2022. PMID: 36477014 Free PMC article.
References
-
- The World Bank. World Bank Country and Lending Groups [Internet]. Data. 2019. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-b...
-
- International Diabetes Federation. IDF Diabetes Atlas. IDF Diabetes Atlas 9th Ed. 2019.
-
- Bommer C, Heesemann E, Sagalova V, Manne-Goehler J, Atun R, Bärnighausen T, et al. The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study. Lancet Diabetes Endocrinol [Internet]. 2017 1 [cited 2018 Dec 3];5(6):423–30. Available from: https://www.sciencedirect.com/science/article/pii/S2213858717300979 - PubMed
-
- IDF. IDF Diabetes Atlas 8th Edition [Internet]. Internasional Diabetes Federation. 2017 [cited 2019 Feb 11]. Available from: https://reports.instantatlas.com/report/view/704ee0e6475b4af885051bcec15...
-
- Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ. Physical activity and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis. Eur J Epidemiol. 2015 Jul 1;30(7):529–42. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous