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Review Article| Volume 378, P140-145, July 15, 2017

Mobile health as a viable strategy to enhance stroke risk factor control: A systematic review and meta-analysis

Published:April 28, 2017DOI:https://doi.org/10.1016/j.jns.2017.04.050

      Highlights

      • Use of mobile health was associated with a significant improvement in glycemic control at 6 months.
      • Use of mobile health was associated with significantly higher rates of smoking cessation at 6 months.
      • There is a paucity of published studies examining longer term impact of mHealth on control of hypertension and hyperlipidemia.

      Abstract

      Background

      With the rapid growth worldwide in cell-phone use, Internet connectivity, and digital health technology, mobile health (mHealth) technology may offer a promising approach to bridge evidence-treatment gaps in stroke prevention. We aimed to evaluate the effectiveness of mHealth for stroke risk factor control through a systematic review and meta-analysis.

      Methods

      We searched PubMed from January 1, 2000 to May 17, 2016 using the following keywords: mobile health, mHealth, short message, cellular phone, mobile phone, stroke prevention and control, diabetes mellitus, hypertension, hyperlipidemia and smoking cessation. We performed a meta-analysis of all eligible randomized control clinical trials that assessed a sustained (at least 6 months) effect of mHealth.

      Results

      Of 78 articles identified, 13 met eligibility criteria (6 for glycemic control and 7 for smoking cessation) and were included for the final meta-analysis. There were no eligible studies for dyslipidemia or hypertension. mHealth resulted in greater Hemoglobin A1c reduction at 6 months (6 studies; 663 subjects; SMD: −0.44; 95% CI: [−0.82, −0.06], P = 0.02; Mean difference of decrease in HbA1c: −0.39%; 95% CI: [−0.74, −0.04], P = 0.03). mHealth also lead to relatively higher smoking abstinence rates at 6 months (7 studies; 9514 subjects; OR: 1.54; 95% CI: [1.24, 1.90], P < 0.0001).

      Conclusions

      Our meta-analysis supports that use of mHealth improves glycemic control and smoking abstinence rates.

      Keywords

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