Mäder Melanie, Schönfelder Tonio, Heinrich Ria, Militzer-Horstmann Carsta, Timpel Patrick
Faculty of Economics and Management Science, Leipzig University, Chair for Health Economics and Management, Leipzig, Germany.
Scientific Institute for Health Economics and Health System Research (WIG2 GmbH), Markt 8, 04109, Leipzig, Germany.
Arch Public Health. 2025 Jan 9;83(1):3. doi: 10.1186/s13690-024-01474-3.
Globally, more than half of the adult population is overweight, including those who are obese, which increases the risk of premature death and reduces quality of life (QoL). Technologies such as digital health applications (DiHA) can potentially improve clinical outcomes (e.g., health status, illness duration, QoL) or patient-related factors (e.g., therapy monitoring, adherence, health literacy). To date, there is no systematic review addressing the effectiveness of DiHA on the QoL in patients with overweight or obesity.
The objective was to investigate the impact of DiHA on QoL in overweight or obese patients.
A systematic literature search was conducted in MEDLINE via PubMed, Cochrane Library, and Embase via Ovid in 2023, supplemented by additional manual searches. The eligibility criteria included patients with overweight and/or obesity who used a digital intervention independently and without interaction with a healthcare professional. The outcome of interest was QoL. As potentially eligible trials had to demonstrate effectiveness, only randomized controlled trials (RCT) were included as the minimum evidence standard. The study screening (title-abstract, full-text) was conducted independently by two researchers using pre-specified eligibility criteria. CONSORT-EHEALTH checklist was used for data extraction of qualitative and quantitative data (study characteristics and study results) and the Cochrane Risk of Bias Tool (version 2) for quality assessment independently by two researchers.
Seven RCT conducted in Europe and the United States were included in this systematic review with a total sample size of N = 946. Observation periods were heterogeneous and ranged from 3 to 24 months. The evaluated interventions consisted of websites or apps, all of which included nutrition and physical activity features, and functioned independently with minimal or no involvement of a healthcare professional. All studies showed a high risk of bias, no statistically significant improvement and no effects regarding QoL using different validated questionnaires.
This systematic review provides a comprehensive analysis of DiHA effectiveness on QoL in patients with overweight or obesity. Overall, there is heterogeneity regarding the operationalization of QoL and the examined interventions have no statistically significant impact on QoL. Comparable systematic reviews show that digital interventions have the potential to improve the QoL of these patients, but further RCT and high-quality studies are needed to assess the impact of DiHA on QoL.
PROSPERO CRD42023408994.
在全球范围内，超过一半的成年人口超重，包括肥胖者，这增加了过早死亡的风险并降低了生活质量（QoL）。数字健康应用程序（DiHA）等技术有可能改善临床结果（如健康状况、疾病持续时间、生活质量）或与患者相关的因素（如治疗监测、依从性、健康素养）。迄今为止，尚无系统评价探讨DiHA对超重或肥胖患者生活质量的有效性。
目的是研究DiHA对超重或肥胖患者生活质量的影响。
2023年通过PubMed在MEDLINE、通过Ovid在Cochrane图书馆和Embase中进行了系统的文献检索，并辅以额外的手工检索。纳入标准包括独立使用数字干预且未与医疗保健专业人员互动的超重和/或肥胖患者。感兴趣的结果是生活质量。由于潜在符合条件的试验必须证明有效性，因此仅纳入随机对照试验（RCT）作为最低证据标准。两名研究人员使用预先指定的纳入标准独立进行研究筛选（标题-摘要、全文）。CONSORT-EHEALTH清单用于定性和定量数据（研究特征和研究结果）的数据提取，两名研究人员独立使用Cochrane偏倚风险工具（第2版）进行质量评估。
本系统评价纳入了在欧洲和美国进行的7项RCT，总样本量为N = 946。观察期各不相同，从3个月到24个月不等。评估的干预措施包括网站或应用程序，所有这些都包括营养和身体活动功能，并且在医疗保健专业人员极少参与或不参与的情况下独立运行。所有研究均显示存在高偏倚风险，使用不同的有效问卷在生活质量方面没有统计学上的显著改善，也没有效果。
本系统评价对DiHA对超重或肥胖患者生活质量的有效性进行了全面分析。总体而言，生活质量的操作化存在异质性，所检查的干预措施对生活质量没有统计学上的显著影响。类似的系统评价表明，数字干预有可能改善这些患者的生活质量，但需要进一步的RCT和高质量研究来评估DiHA对生活质量的影响。
PROSPERO CRD42023408994。
