手机干预措施改善慢性病患者的健康结局:来自 34 项荟萃分析的伞状评价和证据综合

Mobile phone interventions to improve health outcomes among patients with chronic diseases: an umbrella review and evidence synthesis from 34 meta-analyses.

机构信息

Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA; International Health Institute, School of Public Health, Brown University, Providence, RI, USA; Mindfulness Center, School of Public Health, Brown University, Providence, RI, USA.

Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.

出版信息

Lancet Digit Health. 2024 Nov;6(11):e857-e870. doi: 10.1016/S2589-7500(24)00119-5. Epub 2024 Sep 26.

Abstract

This umbrella review of 34 meta-analyses, representing 235 randomised controlled trials done across 52 countries and 48 957 participants and ten chronic conditions, aimed to evaluate evidence on the efficacy of mobile phone interventions for populations with chronic diseases. We evaluated the strengths of evidence via the Fusar-Poli and Radua methodology. Compared with usual care, mobile apps had convincing effects on glycated haemoglobin reduction among adults with type 2 diabetes (d=0·44). Highly suggestive effects were found for both text messages and apps on various outcomes, including medication adherence (among patients with HIV in sub-Saharan Africa and people with cardiovascular disease), glucose management in type 2 diabetes, and blood pressure reduction in hypertension. Many effects (42%) were non-significant. Various gaps were identified, such as a scarcity of reporting on moderators and publication bias by meta-analyses, little research in low-income and lower-middle-income countries, and little reporting on adverse events.

摘要

这是对 34 项荟萃分析的伞式综述,涉及来自 52 个国家的 235 项随机对照试验,涉及 48957 名参与者和 10 种慢性病,旨在评估针对慢性病患者的手机干预措施的疗效证据。我们通过 Fusar-Poli 和 Radua 方法评估了证据的强度。与常规护理相比,移动应用程序在降低 2 型糖尿病成年人的糖化血红蛋白方面具有令人信服的效果(d=0.44)。对于短信和应用程序在各种结果上的影响,包括在撒哈拉以南非洲的 HIV 患者和心血管疾病患者中的药物依从性、2 型糖尿病的血糖管理和高血压的血压降低,都发现了高度提示性的效果。许多效果(42%)并不显著。还确定了各种差距,例如荟萃分析对调节剂和发表偏倚的报告稀缺,在低收入和中低收入国家的研究较少,以及对不良事件的报告较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a851/11534496/275849b8c6b3/nihms-2028955-f0001.jpg

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