Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
Public Health. 2020 Aug;185:356-363. doi: 10.1016/j.puhe.2020.05.024. Epub 2020 Jul 29.
Mobile applications (apps) facilitate aspects of people's lives and are useful auxiliary tools for controlling risk factors for chronic diseases. This meta-analysis and systematic review aimed to explore the effect of app-assisted interventions on blood pressure (BP) control in Chinese adults and summarize the common functions of these apps.
This is a systematic review and meta-analysis.
The search was conducted in four databases (PubMed, Embase, China National Knowledge Infrastructure database, and China Biology Medicine database). The identified articles were reviewed independently by two researchers. A random-effects model was used to compute the effect size. Studies were assessed for risk of bias and the transparency and quality of the apps.
Eighteen studies (n = 2965) were included in the final analysis. App-based interventions achieved additional decreases in BP levels (systolic BP [SBP]: -8.12 mmHg, 95% confidence interval [CI]: -11.47 to -4.77 mmHg, P < 0.001; diastolic BP [DBP]: -6.67 mmHg, 95% CI: -8.92 to -4.41 mmHg, P < 0.001). However, the results showed considerable heterogeneity (SBP: I = 97%, P < 0.001; DBP: I = 96%, P < 0.001). Four studies reported the BP control rate. The pooled results demonstrated a better control rate achieved via app-based interventions (risk ratio: 1.33; 95% CI: 1.18 to 1.49, P < 0.001) without heterogeneity (I = 0%). The transparency and replicability assessment revealed unsatisfying results, and only three studies reported more than half of the 16 items in the mHealth checklist. Few studies described the replicability, data security, and infrastructure of the apps used. We identified 16 app functions, with the top three functions being doctor-patient communication (16/16), health education (15/16), and personalized guidance (12/16).
We showed app-based interventions had a positive effect on BP management in Chinese adults. However, there was high heterogeneity among the included studies, which merits further exploration when more standardized research has been conducted. The functions of the apps varied widely, and further development of apps for BP management should abide by appropriate reporting guidelines.
移动应用程序（apps）方便了人们生活的各个方面，是控制慢性病危险因素的有用辅助工具。本荟萃分析和系统评价旨在探讨应用程序辅助干预对中国成年人血压（BP）控制的影响，并总结这些应用程序的常见功能。
这是一项系统评价和荟萃分析。
在四个数据库（PubMed、Embase、中国国家知识基础设施数据库和中国生物医学数据库）中进行检索。由两名研究人员独立对确定的文章进行审查。使用随机效应模型计算效应量。评估研究的偏倚风险以及应用程序的透明度和质量。
最终分析纳入了 18 项研究（n=2965）。基于应用程序的干预措施使血压水平进一步降低（收缩压[SBP]：-8.12mmHg，95%置信区间[CI]：-11.47 至-4.77mmHg，P<0.001；舒张压[DBP]：-6.67mmHg，95%CI：-8.92 至-4.41mmHg，P<0.001）。然而，结果显示存在很大的异质性（SBP：I=97%，P<0.001；DBP：I=96%，P<0.001）。四项研究报告了 BP 控制率。汇总结果表明，基于应用程序的干预措施具有更好的控制率（风险比：1.33；95%CI：1.18 至 1.49，P<0.001），且无异质性（I=0%）。透明度和可重复性评估显示结果不尽如人意，只有三项研究报告了超过 mHealth 清单 16 项中的一半以上项目。很少有研究描述所使用应用程序的可复制性、数据安全性和基础设施。我们确定了 16 个应用程序功能，其中排名前三的功能是医患沟通（16/16）、健康教育（15/16）和个性化指导（12/16）。
我们表明，基于应用程序的干预措施对中国成年人的 BP 管理有积极影响。然而，纳入的研究存在高度异质性，需要在进行更多标准化研究时进一步探索。应用程序的功能差异很大，进一步开发用于 BP 管理的应用程序应遵守适当的报告指南。
