Vázquez-de Sebastián Julia, Ciudin Andreea, Castellano-Tejedor Carmina
RE-FiT Barcelona Research Group, Vall d'Hebron Institute of Research & Parc Sanitari Pere Virgili, 08023 Barcelona, Spain.
Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain.
J Clin Med. 2021 Jun 18;10(12):2701. doi: 10.3390/jcm10122701.
in diabetes, multiple mHealth solutions were produced and implemented for self-management behaviors. However, little research on the effectiveness of psychological techniques implemented within these mHealth solutions was carried out, and even less with the elderly population where technological barriers might exist. Reliable evidence generated through a comprehensive evaluation of mHealth interventions may accelerate its growth for successful long-term implementation and to help to experience mHealth benefits in an enhanced way in all ages.
this study aimed to review mHealth solutions for diabetes self-management in older adults (adherence to treatments and glycemic control) by analyzing the effectiveness of specific psychological techniques implemented.
a narrative review was conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed (Medline) and American Psychological Association (APA) PsycInfo databases were searched for published papers that addressed eHealth solutions' effectiveness for diabetes self-management. Studies in English, Spanish, and/or German of any design were screened, with no time constraints regarding the year of publication. A qualitative analysis of the selected papers was conducted in several steps.
this review found 38 studies setting up and analyzing mHealth solutions for older adults. Most research showed improvements in HbA1c, self-management behaviors, and medication adherence in T2DM patients post intervention. However, different mid-to-long term effects were found across studies, specifically concerning the maintenance and adherence to healthy behaviors. The most employed psychological framework was CBT, including techniques such as self-monitoring of outcome behaviors (mostly targeting glycemia measurements and healthy habits as physical activity and/or diet), tailored motivational feedback from medical staff, and psychoeducation or health coaches. The most successful mHealth intervention combined the feature of tailored feedback messages, interactive communication with healthcare professionals, and multifaceted functions.
there is a lack of elaborate and detailed information in the literature regarding the factors considered in the design and development of mHealth solutions used as interventions for T2DM self-management in the elderly. Documentation and inclusion of such vital information will foster a transparent and shared decision-making process that will ultimately lead to the development of useful and user-friendly self-management apps that can enhance the quality of life for diabetes patients. Further research adapting mHealth solutions to older adults' sensory deficits is necessary.
在糖尿病领域，人们开发并实施了多种移动健康解决方案以促进自我管理行为。然而，对于这些移动健康解决方案中所采用心理技术的有效性，相关研究较少，而针对可能存在技术障碍的老年人群体的研究则更少。通过对移动健康干预措施进行全面评估得出的可靠证据，可能会加速其发展，以实现长期成功实施，并有助于各年龄段人群更好地体验移动健康带来的益处。
本研究旨在通过分析所采用特定心理技术的有效性，回顾针对老年人糖尿病自我管理（治疗依从性和血糖控制）的移动健康解决方案。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行叙述性综述。在PubMed（Medline）和美国心理学会（APA）的PsycInfo数据库中检索关于电子健康解决方案对糖尿病自我管理有效性的已发表论文。筛选任何设计的英文、西班牙文和/或德文研究，对发表年份无时间限制。对所选论文分几步进行定性分析。
本综述发现38项针对老年人建立和分析移动健康解决方案的研究。大多数研究表明，干预后2型糖尿病患者的糖化血红蛋白、自我管理行为和药物依从性有所改善。然而，不同研究发现了不同的中长期效果，特别是在健康行为的维持和依从性方面。最常用的心理框架是认知行为疗法，包括结果行为自我监测（主要针对血糖测量以及体育活动和/或饮食等健康习惯）、医护人员提供的个性化动机反馈，以及心理教育或健康指导。最成功的移动健康干预措施结合了个性化反馈信息、与医疗保健专业人员的互动交流以及多方面功能的特点。
关于用作老年人2型糖尿病自我管理干预措施的移动健康解决方案在设计和开发中所考虑因素的文献，缺乏详尽和细致的信息。记录并纳入这些重要信息将促进透明且共享的决策过程，最终促成开发出有用且用户友好的自我管理应用程序，从而提高糖尿病患者的生活质量。有必要进一步开展研究，使移动健康解决方案适应老年人的感官缺陷。
