Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: Systematic review and meta-analysis

Dumisani Enricho Nkhoma, Charles Jenya Soko, Kondwani Joseph Banda, David Greenfield, Yu Chuan (Jack) Li, Usman Iqbal

研究成果: 雜誌貢獻回顧型文獻同行評審

摘要

To conduct systematic review and meta-analysis of interventional studies to investigate the impact of diabetes self-management education and support (DSMES) apps on adherence in patients with type 2 diabetes mellitus (T2D). PubMed, Embase, CENTRAL, Web of Science, Scopus and ProQuest were searched, in addition to references of identified articles and similar reviews. Experimental studies, reported in English, assessing DSMES app intervention’s impact on adherence and clinical outcomes of patients with T2D compared with usual care were included. Study bias was assessed using Cochrane Risk of Bias V.2.0 tool. Analysis plan involved narrative synthesis, moderator and meta-analysis. Six randomised controlled trials were included, involving 696 participants (average age 57.6 years, SD 10.59). Mobile apps were mostly used for imputing clinical data, dietary intake or physical activity, and transmitting information to the provider. At 3 months, DSMES apps proved effective in improving medication adherence (standardized mean difference (SMD)=0.393, 95% CI 0.17 to 0.61), glycated haemoglobin (HbA1c) (mean difference (MD)=−0.314, 95% CI −0.477 to –0.151) and Body Mass Index (BMI) (MD=−0.28, 95% CI −0.545 to –0.015). All pooled estimates had low heterogeneity (I20%). Four studies had moderate risk of bias while one each was judged to be low and high risks, respectively. DSMES apps had significant small to moderate effects on medication adherence, HbA1c and BMI of patients with T2D compared with usual care. Apps were described as reliable, easy to use and convenient, though participants were required to be phone literate. Evidence comes from feasibility trials with generally moderate risk of bias. Larger trials with longer follow-up periods using theory-based interventions are required to improve current evidence.
原文英語
文章編號e100291
期刊BMJ Health and Care Informatics
28
發行號1
DOIs
出版狀態已發佈 - 四月 2021

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics
  • Health Information Management

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