The effectiveness of self-management smartphone and tablet apps in long term condition management.
Date Submitted: Jul 1, 2015
Open Peer Review Period: Jul 2, 2015 - Aug 27, 2015
Background: Long term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long term conditions recommend the inclusion of self-management programmes in routine management. Self-management programmes have been associated with improved health outcomes however, the successful and sustainable transfer of research programmes into clinical practice has been inconsistent. Recent developments in mobile technology, such as smartphone and tablet computer apps, could help in developing a platform for the delivery of self- management interventions that are adaptable, low-cost and easily accessible. Objective: We conducted a systematic review to assess the effectiveness of smartphone and tablet apps in self-management of key symptoms of long term conditions. Methods: We searched PubMed, Embase, EBSCO databases, the Cochrane library and Joanna Briggs library for randomised controlled trials that assessed the effectiveness of smartphone and tablet apps in self-management of diabetes mellitus, cardiovascular disease and chronic lung diseases from 2005-2015. Registers of current and ongoing trials were searched and the grey literature. The reference lists of all primary studies and review articles were checked for additional references. The last search was run in June 2015. Results: Six of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised of an app only, three studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). Three studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from a 6 week intervention to 1 year and final follow-up data ranged from 3 months to 1 year. Sample size ranged from 48 to 288 participants. Conclusions: The evidence indicates the potential of apps in improving symptom management through self-management interventions. The use of apps in mHealth has the potential to improve health outcomes among those living with chronic diseases through enhanced symptom control. Further innovation, optimisation, and rigorous research around the potential of apps in mHealth technology will move the field towards the reality of improved health care delivery and outcomes.