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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries

Authors: Victor Stephani, Daniel Opoku, Wilm Quentin

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The reasons of deaths in developing countries are shifting from communicable diseases towards non-communicable diseases (NCDs). At the same time the number of health care interventions using mobile phones (mHealth interventions) is growing rapidly. We review studies assessing the health-related impacts of mHealth on NCDs in low- and middle-income countries (LAMICs).

Methods

A systematic literature search of three major databases was performed in order to identify randomized controlled trials (RCTs) of mHealth interventions. Identified studies were reviewed concerning key characteristics of the trial and the intervention; and the relationship between intervention characteristics and outcomes was qualitatively assessed.

Results

The search algorithms retrieved 994 titles. 8 RCTs were included in the review, including a total of 4375 participants. Trials took place mostly in urban areas, tested different interventions (ranging from health promotion over appointment reminders and medication adjustments to clinical decision support systems), and included patients with different diseases (diabetes, asthma, hypertension). Except for one study all showed rather positive effects of mHealth interventions on reported outcome measures.
Furthermore, our results suggest that particular types of mHealth interventions that were found to have positive effects on patients with communicable diseases and for improving maternal care are likely to be effective also for NCDs.

Conclusions

Despite rather positive results of included RCTs, a firm conclusion about the effectiveness of mHealth interventions against NCDs is not yet possible because of the limited number of studies, the heterogeneity of evaluated mHealth interventions and the wide variety of reported outcome measures. More research is needed to better understand the specific effects of different types of mHealth interventions on different types of patients with NCDs in LaMICs.
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Literature
1.
go back to reference Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008;372(9633):139–44.CrossRefPubMed Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008;372(9633):139–44.CrossRefPubMed
2.
go back to reference Alwan A. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011. Alwan A. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011.
3.
go back to reference Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The global economic burden of noncommunicable diseases. Program on the Global Demography of Aging. 2012. Bloom DE, Cafiero E, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The global economic burden of noncommunicable diseases. Program on the Global Demography of Aging. 2012.
5.
go back to reference Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100(3):191–9.CrossRefPubMed Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100(3):191–9.CrossRefPubMed
8.
go back to reference Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries. Glob Health. 2006;2(9):1–14. Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries. Glob Health. 2006;2(9):1–14.
12.
go back to reference Kahn JG, Yang JS, Kahn JS. ‘Mobile’health needs and opportunities in developing countries. Health Aff. 2010;29(2):252–8.CrossRef Kahn JG, Yang JS, Kahn JS. ‘Mobile’health needs and opportunities in developing countries. Health Aff. 2010;29(2):252–8.CrossRef
13.
go back to reference Mbuagbaw L, Mursleen S, Lytvyn L, Smieja M, Dolovich L, Thabane L. Mobile phone text messaging interventions for HIV and other chronic diseases: an overview of systematic reviews and framework for evidence transfer. BMC Health Serv Res. 2015;15(1):33.CrossRefPubMedPubMedCentral Mbuagbaw L, Mursleen S, Lytvyn L, Smieja M, Dolovich L, Thabane L. Mobile phone text messaging interventions for HIV and other chronic diseases: an overview of systematic reviews and framework for evidence transfer. BMC Health Serv Res. 2015;15(1):33.CrossRefPubMedPubMedCentral
14.
15.
go back to reference Beratarrechea A, Lee AG, Willner JM, Jahangir E, Ciapponi A, Rubinstein A. The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review. Telemed E Health. 2014;20(1):75–82.CrossRef Beratarrechea A, Lee AG, Willner JM, Jahangir E, Ciapponi A, Rubinstein A. The impact of mobile health interventions on chronic disease outcomes in developing countries: a systematic review. Telemed E Health. 2014;20(1):75–82.CrossRef
16.
go back to reference Bloomfield GS, Vedanthan R, Vasudevan L, Kithei A, Were M, Velazquez EJ. Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research. Glob Health. 2014;10(1):49.CrossRef Bloomfield GS, Vedanthan R, Vasudevan L, Kithei A, Were M, Velazquez EJ. Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research. Glob Health. 2014;10(1):49.CrossRef
17.
18.
go back to reference Matthews JN. Introduction to randomized controlled clinical trials. 1st ed. Boca Raton: CRC Press; 2006.CrossRef Matthews JN. Introduction to randomized controlled clinical trials. 1st ed. Boca Raton: CRC Press; 2006.CrossRef
21.
go back to reference Howitt P, Darzi A, Yang G-Z, Ashrafian H, Atun R, Barlow J, et al. Technologies for global health. Lancet. 2012;380(9840):507–35.CrossRefPubMed Howitt P, Darzi A, Yang G-Z, Ashrafian H, Atun R, Barlow J, et al. Technologies for global health. Lancet. 2012;380(9840):507–35.CrossRefPubMed
22.
go back to reference Reeves BC, Deeks JJ, Higgins JP. 13 Including non-randomized studies. Cochrane Handb Syst Rev Interv. 2008;1:391. Reeves BC, Deeks JJ, Higgins JP. 13 Including non-randomized studies. Cochrane Handb Syst Rev Interv. 2008;1:391.
23.
go back to reference Piette JD, Datwani H, Gaudioso S, Foster SM, Westphal J, Perry W, et al. Hypertension management using mobile technology and home blood pressure monitoring: results of a randomized trial in two low/middle-income countries. Telemed E Health. 2012;18(8):613–20.CrossRef Piette JD, Datwani H, Gaudioso S, Foster SM, Westphal J, Perry W, et al. Hypertension management using mobile technology and home blood pressure monitoring: results of a randomized trial in two low/middle-income countries. Telemed E Health. 2012;18(8):613–20.CrossRef
24.
go back to reference Tian M, Ajay V, Dunzhu D, Hameed S, Li X, Liu Z, et al. A cluster-randomized controlled trial of a simplified multifaceted management program for individuals at high cardiovascular risk (SimCard Trial) in Rural Tibet, China, and Haryana, India. Circulation. 2015;132(9):815–24.CrossRefPubMedPubMedCentral Tian M, Ajay V, Dunzhu D, Hameed S, Li X, Liu Z, et al. A cluster-randomized controlled trial of a simplified multifaceted management program for individuals at high cardiovascular risk (SimCard Trial) in Rural Tibet, China, and Haryana, India. Circulation. 2015;132(9):815–24.CrossRefPubMedPubMedCentral
26.
go back to reference Shetty AS, Chamukuttan S, Nanditha A, Raj R, Ramachandran A. Reinforcement of adherence to prescription recommendations in Asian Indian diabetes patients using short message service (SMS)–a pilot study. J Assoc Physicians India. 2011;59:711–4.PubMed Shetty AS, Chamukuttan S, Nanditha A, Raj R, Ramachandran A. Reinforcement of adherence to prescription recommendations in Asian Indian diabetes patients using short message service (SMS)–a pilot study. J Assoc Physicians India. 2011;59:711–4.PubMed
27.
go back to reference Shahid M, Mahar SA, Shaikh S, Shaikh Z. Mobile phone intervention to improve diabetes care in rural areas of pakistan: a randomized controlled trial. J College of Physicians Surg Pak. 2015;25(3):166–71. Shahid M, Mahar SA, Shaikh S, Shaikh Z. Mobile phone intervention to improve diabetes care in rural areas of pakistan: a randomized controlled trial. J College of Physicians Surg Pak. 2015;25(3):166–71.
28.
go back to reference Liu W-T, Huang C-D, Wang C-H, Lee K-Y, Lin S-M, Kuo H-P. A mobile telephone-based interactive self-care system improves asthma control. Eur Respir J. 2011;37(2):310–7.CrossRefPubMed Liu W-T, Huang C-D, Wang C-H, Lee K-Y, Lin S-M, Kuo H-P. A mobile telephone-based interactive self-care system improves asthma control. Eur Respir J. 2011;37(2):310–7.CrossRefPubMed
29.
go back to reference Ostojic V, Cvoriscec B, Ostojic SB, Reznikoff D, Stipic-Markovic A, Tudjman Z. Improving asthma control through telemedicine: a study of short-message service. Telemed J E Health. 2005;11(1):28–35.CrossRefPubMed Ostojic V, Cvoriscec B, Ostojic SB, Reznikoff D, Stipic-Markovic A, Tudjman Z. Improving asthma control through telemedicine: a study of short-message service. Telemed J E Health. 2005;11(1):28–35.CrossRefPubMed
30.
go back to reference Liew S-M, Tong SF, Lee VKM, Ng CJ, Leong KC, Teng CL. Text messaging reminders to reduce non-attendance in chronic disease follow-up: a clinical trial. Br J Gen Pract. 2009;59(569):916–20.CrossRefPubMedPubMedCentral Liew S-M, Tong SF, Lee VKM, Ng CJ, Leong KC, Teng CL. Text messaging reminders to reduce non-attendance in chronic disease follow-up: a clinical trial. Br J Gen Pract. 2009;59(569):916–20.CrossRefPubMedPubMedCentral
31.
go back to reference Gurman TA, Rubin SE, Roess AA. Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun. 2012;17(sup1):82–104.CrossRefPubMed Gurman TA, Rubin SE, Roess AA. Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. J Health Commun. 2012;17(sup1):82–104.CrossRefPubMed
32.
go back to reference Velthoven M, Brusamento S, Majeed A, Car J. Scope and effectiveness of mobile phone messaging for HIV/AIDS care: a systematic review. Psychol Health Med. 2013;18(2):182–202.CrossRefPubMed Velthoven M, Brusamento S, Majeed A, Car J. Scope and effectiveness of mobile phone messaging for HIV/AIDS care: a systematic review. Psychol Health Med. 2013;18(2):182–202.CrossRefPubMed
33.
go back to reference Déglise C, Suggs LS, Odermatt P. SMS for disease control in developing countries: a systematic review of mobile health applications. J Telemed Telecare. 2012;18(5):273–81.CrossRefPubMed Déglise C, Suggs LS, Odermatt P. SMS for disease control in developing countries: a systematic review of mobile health applications. J Telemed Telecare. 2012;18(5):273–81.CrossRefPubMed
34.
go back to reference Lau YK, Cassidy T, Hacking D, Brittain K, Haricharan HJ, Heap M. Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study. BMC Pregnancy Childbirth. 2014;14(1):284.CrossRefPubMedPubMedCentral Lau YK, Cassidy T, Hacking D, Brittain K, Haricharan HJ, Heap M. Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study. BMC Pregnancy Childbirth. 2014;14(1):284.CrossRefPubMedPubMedCentral
35.
go back to reference Fedha T. Impact of mobile telephone on maternal health service care: a case of Njoro division. Open J Prev Med. 2014;4(No.5):2014.CrossRef Fedha T. Impact of mobile telephone on maternal health service care: a case of Njoro division. Open J Prev Med. 2014;4(No.5):2014.CrossRef
36.
go back to reference Lund S, Hemed M, Nielsen BB, Said A, Said K, Makungu M, Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster‐randomised controlled trial. BJOG. 2012;119(10):1256–64.CrossRefPubMed Lund S, Hemed M, Nielsen BB, Said A, Said K, Makungu M, Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster‐randomised controlled trial. BJOG. 2012;119(10):1256–64.CrossRefPubMed
37.
go back to reference Thirumurthy H, Lester RT. M-health for health behaviour change in resource-limited settings: applications to HIV care and beyond. Bull World Health Organ. 2012;90(5):390–2.CrossRefPubMedPubMedCentral Thirumurthy H, Lester RT. M-health for health behaviour change in resource-limited settings: applications to HIV care and beyond. Bull World Health Organ. 2012;90(5):390–2.CrossRefPubMedPubMedCentral
38.
go back to reference Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, De Walque D, Mackeen L, Haberer J, Kimaiyo S, Sidle J. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS (London, England). 2011;25(6):825.CrossRef Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, De Walque D, Mackeen L, Haberer J, Kimaiyo S, Sidle J. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS (London, England). 2011;25(6):825.CrossRef
39.
go back to reference Zurovac D, Larson BA, Sudoi RK, Snow RW. Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers’ adherence to malaria guidelines in Kenya. PLoS One. 2012;7(12):e52045.CrossRefPubMedPubMedCentral Zurovac D, Larson BA, Sudoi RK, Snow RW. Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers’ adherence to malaria guidelines in Kenya. PLoS One. 2012;7(12):e52045.CrossRefPubMedPubMedCentral
40.
go back to reference Fruhauf J, Hofman-Wellenhof R, Kovarik C, Mulyowa G, Alitwala C, Soyer HP, Kaddu S. Mobile teledermatology in sub-Saharan Africa: a useful tool in supporting health workers in low-resource centres. Acta Derm Venereol. 2013;93(1):122–3.CrossRefPubMed Fruhauf J, Hofman-Wellenhof R, Kovarik C, Mulyowa G, Alitwala C, Soyer HP, Kaddu S. Mobile teledermatology in sub-Saharan Africa: a useful tool in supporting health workers in low-resource centres. Acta Derm Venereol. 2013;93(1):122–3.CrossRefPubMed
41.
go back to reference Quinley KE, Gormley RH, Ratcliffe SJ, Shih T, Szep Z, Steiner A, Ramogola-Masire D, Kovarik CL. Use of mobile telemedicine for cervical cancer screening. J Telemed Telecare. 2011;17(4):203–9.CrossRefPubMedPubMedCentral Quinley KE, Gormley RH, Ratcliffe SJ, Shih T, Szep Z, Steiner A, Ramogola-Masire D, Kovarik CL. Use of mobile telemedicine for cervical cancer screening. J Telemed Telecare. 2011;17(4):203–9.CrossRefPubMedPubMedCentral
42.
go back to reference Tran K, Ayad M, Weinberg J, Cherng A, Chowdhury M, Monir S, El Hariri M, Kovarik C. Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases. J Am Acad Dermatol. 2011;64(2):302–9.CrossRefPubMed Tran K, Ayad M, Weinberg J, Cherng A, Chowdhury M, Monir S, El Hariri M, Kovarik C. Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases. J Am Acad Dermatol. 2011;64(2):302–9.CrossRefPubMed
43.
go back to reference Desai S, Patil R, Chinoy R, Kothari A, Ghosh T, Chavan M, Mohan A, Nene B, Dinshaw K. Experience with telepathology at a tertiary cancer centre and a rural cancer hospital. Natl Med J India. 2004;17(1):17.PubMed Desai S, Patil R, Chinoy R, Kothari A, Ghosh T, Chavan M, Mohan A, Nene B, Dinshaw K. Experience with telepathology at a tertiary cancer centre and a rural cancer hospital. Natl Med J India. 2004;17(1):17.PubMed
44.
go back to reference Stephani V, Opoku D, Quentin W. Does mHealth contribute to improved care for people with non-communicable diseases in developing countries? Working papers in health policy and management. 2015. p. 10. Stephani V, Opoku D, Quentin W. Does mHealth contribute to improved care for people with non-communicable diseases in developing countries? Working papers in health policy and management. 2015. p. 10.
Metadata
Title
A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries
Authors
Victor Stephani
Daniel Opoku
Wilm Quentin
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3226-3

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