Background: mobile health (mHealth) is used to strengthen patients’ self-care management, facilitate communication between patients and service providers, provide information to improve health behaviours and decision making, prevent health-related complications, and improve health-related quality of life. Among chronic diseases, type 2 diabetes is a critical health problem with increasing incidence, prevalence, and complications worldwide.
Objectives: this scoping review of systematic reviews and meta-analyses concerning mHealth interventions aimed to examine service platforms, program types, outcomes of interest, current status of research activities, and effectiveness for type 2 diabetes self-care management among community-dwelling adults, and identify research gaps.
Methods: this scoping review adopted the method developed by Arksey and O’Malley. The databases searched were Ovid Medline and Ovid Embase, and the period was from inception until April 2018. Two review authors independently screened, selected, and charted studies using a piloted charting form. Discrepancies were resolved by consensus, after which the results were collated, summarized, and thematically analyzed.
Results: the final sample (n = 81) included systematic reviews or meta-analyses reporting the clinical effectiveness of mHealth interventions (n = 64), behavioural outcomes related to mHealth interventions (n = 47), and the usability of mHealth interventions (n =1 4). The most common subtypes of mHealth interventions for type 2 diabetes care were patient monitoring (32.5%), treatment adherence (30.7%), and diabetes-related advice and education (20.9%). Mobile devices were most often used to provide such mHealth services (40%), followed by the internet (28.9%). The mHealth intervention strategy that was effective for controlling blood glucose in patients with type 2 diabetes was a multimodal intervention consisting of treatment advice and education, treatment adherence/reminder methods, and patient monitoring. The intervention strategy that showed behavioural effects was the one consisting of treatment adherence/reminder methods and/or patient monitoring. The usability of mHealth interventions was controversial.
Conclusions: in order to improve clinical and behavioural outcomes, the process of applying mHealth interventions should include strategies for improving interaction between patients and healthcare service providers. Systematic reviews of mHealth interventions using comprehensive mobile apps, containing at least three major components of treatment advice, reminders, patient monitoring, and social networking services are needed. In addition, systematic reviews on the effectiveness of mHealth interventions in pre-diabetics are needed.
Patient or healthcare consumer involvement: not applicable