School of Information Studies, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
Department of Social Work, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
J Am Med Inform Assoc. 2020 Jun 1;27(6):939-945. doi: 10.1093/jamia/ocaa029.
This article reports results from a systematic literature review of the current state of mobile health (mHealth) technologies that have the potential to support self-management for people with diabetes and hypertension. The review aims to (a) characterize mHealth technologies used or described in the mHealth literature and (b) summarize their effects on self-management for people with diabetes and hypertension from the clinical and technical standpoints.
A systematic literature review was conducted following PRISMA guidelines. Online databases were searched in September 2018 to identify eligible studies for review that had been published since 2007, the start of the smartphone era. Data were extracted from included studies based on the PICOS framework.
Of the 11 studies included for in-depth review, 5 were clinical research examining patient health outcomes and 6 were technology-focused studies examining users' experiences with mHealth technologies under development. The most frequently used mHealth technology features involved self-management support (n = 11) followed by decision support (n = 6) and shared decision-making (n = 6). Most clinical studies reported benefits associated with mHealth interventions. These included reported improvements in objectively measured patient health outcomes (n = 3) and perceptual or behavioral outcomes (n = 4).
Although most studies reported promising results in terms of the effects of mHealth interventions on patient health outcomes and experience, the strength of evidence was limited by the study designs.
More randomized clinical trials are needed to examine the promise and limitations of mHealth technologies as assistive tools to facilitate the self-management of highly prevalent comorbidity of chronic conditions, such as diabetes and hypertension.
本文报告了对具有支持糖尿病和高血压患者自我管理潜力的移动医疗（mHealth）技术的当前状态进行系统文献回顾的结果。该综述旨在：（a）描述 mHealth 文献中使用或描述的 mHealth 技术；（b）从临床和技术角度总结这些技术对糖尿病和高血压患者自我管理的影响。
按照 PRISMA 指南进行了系统文献回顾。2018 年 9 月，在线数据库被搜索以确定符合条件的研究进行综述，这些研究自智能手机时代（2007 年）开始以来已经发表。根据 PICOS 框架，从纳入的研究中提取数据。
在纳入的 11 项深入审查的研究中，有 5 项是临床研究，检查了患者的健康结果，有 6 项是技术重点研究，检查了正在开发的 mHealth 技术的用户体验。最常使用的 mHealth 技术功能涉及自我管理支持（n=11），其次是决策支持（n=6）和共享决策（n=6）。大多数临床研究报告了与 mHealth 干预相关的益处。这些益处包括报告的客观测量的患者健康结果的改善（n=3）和知觉或行为结果的改善（n=4）。
尽管大多数研究报告了 mHealth 干预对患者健康结果和体验的影响的有希望的结果，但证据的强度受到研究设计的限制。
需要更多的随机临床试验来检验 mHealth 技术作为辅助工具促进常见慢性病（如糖尿病和高血压）的自我管理的潜力和局限性。
