Garabedian Laura F, Ross-Degnan Dennis, Wharam J Frank
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Ave, 6th Floor, Boston, MA, 02215, USA.
Curr Diab Rep. 2015 Dec;15(12):109. doi: 10.1007/s11892-015-0680-8.
Mobile and smartphone (mHealth) technologies have the potential to improve diabetes care and self-management, but little is known about their effectiveness and how patients, providers, and payers currently interact with them. We conducted a systematic review and found only 20 peer-reviewed articles, published since 2010, with robust evidence about the effectiveness of mHealth interventions for diabetes. The majority of these interventions showed improvement on primary endpoints, such as HbA1c; mHealth technologies that interacted with both patients and providers were more likely to be effective. There was little evidence about persistent use by patients, use by a patient's health care provider, or long-term effectiveness. None of the studies discussed regulatory oversight of mHealth technologies or payer reimbursement for them. No robust studies evaluated the more than 1100 publicly available smartphone apps for diabetes. More research with valid study designs and longer follow-up is needed to evaluate the impact of mHealth technologies for diabetes care and self-management.
移动和智能手机(移动健康)技术有改善糖尿病护理和自我管理的潜力,但对于它们的有效性以及患者、医疗服务提供者和支付方目前如何与之互动,我们知之甚少。我们进行了一项系统综述,发现自2010年以来仅有20篇经过同行评审的文章,提供了关于移动健康干预措施对糖尿病有效性的确凿证据。这些干预措施中的大多数在诸如糖化血红蛋白等主要终点指标上显示出改善;与患者和医疗服务提供者都有互动的移动健康技术更有可能有效。关于患者持续使用、患者的医疗服务提供者使用或长期有效性的证据很少。没有研究讨论对移动健康技术的监管监督或支付方对它们的报销情况。没有强有力的研究评估超过1100款公开可用的糖尿病智能手机应用程序。需要更多具有有效研究设计和更长随访期的研究来评估移动健康技术对糖尿病护理和自我管理的影响。