While there is some evidence supporting the efficacy of mobile health interventions for patients with diabetes, the quality of past studies is substandard and additional research on efficacy is needed.
That’s the conclusion of a new study, published March 1 in the journal PLoS ONE, that was designed to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for diabetic patients.
Researchers conducted a comprehensive search on multiple databases to identify relevant systematic reviews published between January 1996 and December 2015. Based on that search, they independently identified 15 reviews published between 2008 and 2014 that were eligible for inclusion in the study, extracted data using an electronic form and assessed the methodological quality of those reviews.
“The quality of the reviews varied considerably, and most of them had important methodological limitations,” researchers found. The overview discovered that, “on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8 percent for patients with type 2 diabetes and 0.3 percent 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.”
Spyros Kitsiou, an assistant professor in the Department of Biomedical and Health Information Sciences at the University of Illinois-Chicago’s College of Health Sciences and an author of the article, says that overall the rigor of mHealth research—both randomized controlled trials and systematic reviews—must be improved because it is “not methodologically sound” and has many weaknesses.
“There are many issues that create risks of bias in terms of the interpretation of results,” says Kitsiou.
Despite these limitations, Kitsiou and his colleagues contend that mHealth interventions represent a promising approach for patients who want to manage their diabetes.
“Based on the available evidence, which is of moderate quality, we saw quantitative effects,” he observes, adding that, “mHealth appears to be more effective for type 2 diabetes.”
According to the article’s authors, further research should focus on exploring the use and impact of diabetes mobile apps that are publicly available through the Apple and Google Play stores.
“Most trials included in the systematic reviews involved proprietary applications that are not available to the general public,” concludes the article. “However, as the rates of smartphone ownership and availability of diabetes self-management apps increase, it is important to investigate the safety and clinical effectiveness of these apps.”
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