M-Health Monitor: Evidence on Effects of Mobile Health Technology, February 2016

Here, we summarise the studies on the use of mobile health technology (m-Health) that were indexed in PubMed in February 2016.

Mobile health technology includes the use of smartphones, telemonitoring, mobile apps and similar online tools and devices to educate patients, caregivers and health professionals about disease, to promote healthy living in the general public, and to provide an interactive platform to aid communication and feedback between individuals and those helping them manage their disease. Although evidence of clinical benefit from such technologies is relatively sparse, there is a growing evidence base on the topic.

In this blog, we are building on previous summaries of the evidence on this topic by reviewing papers indexed in PubMed in February 2016 reporting results of studies evaluating m-Health technologies.

Links to our previous summaries:
July 2015
August 2015
September 2015
October 2015
November 2015
December 2015
January 2016

Key studies this month:

  • Eleven studies found that m-Health interventions were as effective as face-to-face, traditional care in improving symptoms or quality of life or assisting clinicians with disease management, with some also demonstrating time savings for patients and/or clinicians.

Several studies found benefits from m-Health interventions compared with usual care:

  • A systematic review of 5 studies found that SMS text messages may improve adherence with contraception Smith et al. 2015(external link)
  • A systematic review found telemedicine interventions can promote positive behaviour changes and help manage type 2 diabetes Jalil et al. 2015 (external link)
  • A systematic review of 11 studies found that most reported greater weight loss and increased physical activity in obese adults using electronic activity monitoring systems than control groups Lewis et al. 2015(external link)
  • Telephone-based counselling with CBT and work coaching improved productivity and depression in US employees significantly more than usual care Lerner et al. 2015(external link)
  • SMS messaging, advice and tele-coaching improved exercise capacity and quality of life compared with usual care in Belgian cardiac rehabilitation patients Frederix et al. 2015(external link)

However, 2 studies found that outcomes might be worse with telemedicine:

  • Telemedicine surveillance by a trained nurse led to worse outcomes and greater healthcare resource use than outpatient follow-up in Dutch patients with COPD Berkhof et al. 2015(external link)
  • Computerised alerts to the receiving hospital reduced door-to-balloon time for percutaneous coronary angiography in the UK, but there was a non-significant trend to higher mortality compared with the previous system Brown et al. 2015(external link)


Papers looking at m-Health to promote healthy living in the general public

Population m-Health technology used Outcome Clinically important outcome relating to m-Health intervention? Reference
Systematic review of 11 studies of overweight or obese adults receiving interventions to increase physical activity Electronic activity monitoring systems Most studies found significant improvements in physical activity or weight loss by the end of the study with good adherence Yes Lewis et al. 2015(external link)
Patients with type 2 diabetes or chronic obstructive pulmonary disease (COPD)who are insufficiently active, registered at 24 family practices It’s Life! mobile and web-based monitoring and feedback tool plus self management support program vs support program alone vs usual care for 6 months Significantly more physical activity in the It’s Life! group at end of the study and for following 3 months compared with other two groups, no significant difference between other 2 groups No van der Weegen et al. 2015(external link)
110 insufficiently active adults Facebook app web-based social networking physical activity intervention with pedometer vs waiting list control Significantly greater moderate to vigorous activity in intervention group at study end at 8 weeks, no difference by 20 weeks Significantly greater moderate to vigorous activity in intervention group at study end at 8 weeks, no difference by 20 weeks Maher et al. 2015(external link)
11,651 general public users of the program 10,000 Steps Australia physical activity promotion App vs website vs both 50% of users stopped logging activity data by 30 days; attrition lower with users of app vs web only No Guertler et al. 2015 (external link)
US families Utahfamilymeals.org web site and social media campaign using Facebook, Twitter for healthy eating After 1 month, campaign had reached 10-12% of target population, cost 0.2 cents/person No Lister et al. 2015 (external link)
Review of literature Smartphone wearable ambulatory monitorsto sense human movement Overview of sensors and algorithms to classify human movement No del Rosario et al. 2015 (external link)
7 healthy volunteers Smartphone monitoring of different types of physical activity Best decision-tree classifier has 89.6% accuracy for detecting different movements No Miao et al. 2015(external link)
28 university students ActiGraph accelerometer to detect different types of physical activity vs direct researcher observation Accelerometer metrics had 95-98% accuracy, inclinometer accuracy 71% No Peterson et al. 2015 (external link)
175 older women Accelerometer to be worn 24 hours a day for 9 consecutive days, daily logs Analysis algorithm and visual inspection of data had 74% and 81% agreement with logs on accelerometer usage No Rillamas-Sun et al. 2015 (external link)
111 elderly adults aged 70-79 years Actigraph accelerometer threshold determination compared with VO2max maximal oxygen intake Thresholds for moderate intensity activity 669-3,367 counts/minute (CPM) for women, 834-4,048 CPM for men; vigorous intensity 1,625-4,868 CPM for women, 2,012-5,423 CPM for men No Zisko et al. 2015 (external link)

Studies using m-Health to improve attendance at healthcare appointments or adherence with treatment

Population m-Health technology used Outcome Clinically important outcome relating to m-Health intervention? Reference
Users of inhalers for asthma and COPD Electronic monitoring devicesto measure adherence to inhalers Overview of information for clinicians No Chan et al. 2015(external link)
5,184 gastroenterology outpatients, Denmark Telephone reminders 1 day before clinic appointment vs no reminder Non-attendance was 6% in reminded group vs 10.5% in control group; 64% answered the call, and only 1.3% of these did not attend; reminders were cost-effective No Jeppersen and Ainsworth 2015(external link)
Systematic review of 14 studies on self-administered survey responders Mobile apps vs other methods of data collection Similar response rates from apps and other methods No Marcano Belisario et al. 2015 (external link)

Studies using m-Health to improve disease management and self-management

Population m-Health technology used Outcome Clinically important outcome relating to m-Health intervention? Reference
Systematic review of studies in type 2 diabetes Telemedicine interventions Telemedicine can promote positive behaviour changes and help manage diabetes Yes Jalil et al. 2015 (external link)
267 adults with heart disease, 250 with diabetes, Finland Telemonitoring and mobile phone-based health coaching vs usual care No difference in quality of life on SF-36 or diabetes control Yes Karhula et al. 2015 (external link)
61 low-income adults with diabetes on insulin, US SMS messaging of fasting blood glucose levels, phone calls to adjust insulin dose if necessary vs usual care 88% of intervention group reached target insulin glargine dose vs 37% of controls, greater satisfaction with intervention, which saved 84 minutes of patient time and was cost-saving No Levy et al. 2015 (external link)
140 cardiac rehabilitationpatients, Belgium Telerehabilitation with SMS messaging, advice and patient-tailored semi-automatic telecoaching by email vs conventional rehabilitation Significantly greater improvement in exercise capacity, quality of life in intervention group at 24 weeks Yes Frederix et al. 2015(external link)
131 adults with heart failure, Poland Home-based telerehabilitation vs outpatient rehabilitation Similar improvement in SF-36 quality of life scores in both groups by 8 weeks Yes
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