Virella Pérez Yisselle Ilene, Medlow Sharon, Ho Jane, Steinbeck Katharine
The Children's Hospital at Westmead, Academic Department of Adolescent Medicine, Westmead, New South Wales, Australia.
The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, New South Wales, Australia.
J Med Internet Res. 2019 Nov 20;21(11):e13579. doi: 10.2196/13579.
More adolescents with chronic physical illness are living into adulthood, and they require the development of proficient self-management skills to maintain optimal physical health as they transition into adult care services. It is often during this vulnerable transition period that deterioration in illness control is seen as a result of inadequate self-management skills and understanding of their chronic illness. Mobile technology has been proposed as an innovative opportunity to assist in improving the management of chronic conditions as young people transition to adult care services. Over the past 5 years, there has been a significant increase in research into the use of health-related apps.
This study aimed to evaluate the utility and effectiveness of mobile and Web-based health apps that support self-management and transition in young people with chronic physical health illnesses.
We conducted a comprehensive review of the literature in 5 bibliographic databases, using key search terms, considering only articles published from 2013, as we were extending the data from 2 previous systematic reviews. Abstracts were screened for possible inclusion by 2 reviewers. Data extraction and quality assessment tools were used for the evaluation of included studies.
A total of 1737 records were identified from the combined electronic searches, and 854 records were removed as duplicates. A total of 68 full articles were further assessed for eligibility, and 6 articles met our review criteria: 3 pilot studies, 2 randomized controlled trials, and 1 prospective cohort study. Publication years ranged from 2015 to 2018. The apps reported were targeted at type 1 diabetes mellitus, epilepsy, asthma, beta thalassemia major, and sickle cell disease, with a combined sample size of 336. A total of 4 studies included in this review reported being effective in increasing knowledge of the targeted condition and increasing therapy adherence, including increased medication adherence. A total of 2 manuscripts only mentioned the word transition. Participant's satisfaction was reported for all studies. Heterogeneity of the studies prevented meta-analysis.
There remain limited data on the effectiveness and use of mobile and Web-based apps, which might facilitate the transition of adolescents with chronic illnesses from pediatric to adult health care services. This systematic review provides an updated overview of available apps for adolescents with chronic illnesses. This systematic review has been unable to provide evidence for effectiveness of this approach, but it does provide insights into future study design, with reference to the development, evaluation, and efficacy of apps tailored for adolescents with chronic illnesses, including the involvement of adolescents in such designs.
PROSPERO CRD42018104611; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=104611.
越来越多患有慢性身体疾病的青少年步入成年期，在他们过渡到成人护理服务时，需要培养熟练的自我管理技能以维持最佳身体健康状态。在这个脆弱的过渡阶段，往往会因自我管理技能不足以及对慢性病的了解不够而导致疾病控制恶化。移动技术被视为一种创新契机，可在年轻人向成人护理服务过渡时协助改善慢性病管理。在过去5年中，对健康相关应用程序使用情况的研究显著增加。
本研究旨在评估支持患有慢性身体健康疾病的年轻人进行自我管理和过渡的移动及基于网络的健康应用程序的效用和有效性。
我们在5个文献数据库中进行了全面的文献综述，使用关键检索词，仅考虑2013年以来发表的文章，因为我们在扩展之前两项系统评价的数据。由两名评审员筛选摘要以确定是否可能纳入。使用数据提取和质量评估工具对纳入研究进行评估。
通过综合电子检索共识别出1737条记录，其中854条记录作为重复项被剔除。共对68篇全文进行了进一步的资格评估，6篇文章符合我们的综述标准：3项试点研究、2项随机对照试验和1项前瞻性队列研究。发表年份从2015年到2018年。所报告的应用程序针对1型糖尿病、癫痫、哮喘、重型β地中海贫血和镰状细胞病，样本量共计336例。本综述纳入的4项研究报告称，这些应用程序在增加对目标疾病的了解和提高治疗依从性（包括提高药物依从性）方面有效。共有2篇手稿仅提及了“过渡”一词。所有研究均报告了参与者的满意度。研究的异质性妨碍了进行荟萃分析。
关于移动和基于网络的应用程序的有效性和使用情况的数据仍然有限，这些应用程序可能有助于患有慢性病的青少年从儿科医疗服务过渡到成人医疗服务。本系统评价提供了针对患有慢性病的青少年的现有应用程序的最新概述。本系统评价无法提供这种方法有效性的证据，但它确实为未来的研究设计提供了见解，涉及为患有慢性病的青少年量身定制的应用程序的开发、评估和疗效，包括青少年参与此类设计。
PROSPERO CRD42018104611；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=104611
