- •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.
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.
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.
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).
Our meta-analysis supports that use of mHealth improves glycemic control and smoking abstinence rates.
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- Heart disease and stroke statistics—2015 update: a report from the American Heart Association.Circulation. 2015; 131: e29-322
- Heart disease and stroke statistics—2014 update: a report from the American Heart Association.Circulation. 2014; 129: e28-e292
- Duration of diabetes and risk of ischemic stroke: the Northern Manhattan Study.Stroke. 2012; 43: 1212-1217
- Long-term risk factors for stroke: twenty-eight years of follow-up of 7457 middle-aged men in Goteborg, Sweden.Stroke. 2006; 37: 1663-1667
- Consistency of blood pressure control after ischemic stroke: prevalence and prognosis.Stroke. 2014; 45: 1313-1317
- Impact of nonadherence to antihypertensive therapy.Circulation. 2009; 120: 1558-1560
- Personal health technology: a new era in cardiovascular disease prevention.Postgrad. Med. 2015; 127: 150-158
- Mobile health initiatives to improve outcomes in primary prevention of cardiovascular disease.Curr. Treat. Options Cardiovasc. Med. 2015; 17: 59
- Mobile health devices as tools for worldwide cardiovascular risk reduction and disease management.Circulation. 2015; 132: 2012-2027
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.PLoS Med. 2009; 6e1000097
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.PLoS Med. 2009; 6e1000100
- Impact of the “Diabetes Interactive Diary” telemedicine system on metabolic control, risk of hypoglycemia, and quality of life: a randomized clinical trial in type 1 diabetes.Diabetes Technol. Ther. 2013; 15: 670-679
- Mobile phone-based video messages for diabetes self-care support.J. Diabetes Sci. Technol. 2012; 6: 310-319
- The Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support improves HbA1c in poorly controlled type 1 diabetic patients: a 6-month, randomized, open-label, parallel-group, multicenter trial (TeleDiab 1 Study).Diabetes Care. 2011; 34: 533-539
- Diabetes Interactive Diary: a new telemedicine system enabling flexible diet and insulin therapy while improving quality of life: an open-label, international, multicenter, randomized study.Diabetes Care. 2010; 33: 109-115
- Web-based comprehensive information system for self-management of diabetes mellitus.Diabetes Technol. Ther. 2010; 12: 333-337
- One-year efficacy and safety of Web-based follow-up using cellular phone in type 1 diabetic patients under insulin pump therapy: the PumpNet study.Diabete Metab. 2007; 33: 220-226
- Randomized controlled trial to assess the short-term effectiveness of tailored web- and text-based facilitation of smoking cessation in primary care (iQuit in practice).Addiction. 2014; 109: 1184-1193
- A randomized trial of Text2Quit: a text messaging program for smoking cessation.Am. J. Prev. Med. 2014; 47: 242-250
- A theory-based video messaging mobile phone intervention for smoking cessation: randomized controlled trial.J. Med. Internet Res. 2011; 13e10
- Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial.Lancet (Lond. Engl.). 2011; 378: 49-55
- A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial.J. Med. Internet Res. 2008; 10e51
- Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention.Addiction. 2008; 103 (discussion 85-6): 478-484
- Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging.Tob. Control. 2005; 14: 255-261
- Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis.Prim. Care Diabetes. 2014; 8: 275-285
- Diabetes Res. Clin. Pract. 2014; 105: 271-272
- Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014; 45: 2160-2236
- Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014; 45: 3754-3832
Published online: April 28, 2017
Accepted: April 28, 2017
Received in revised form: April 12, 2017
Received: January 31, 2017
© 2017 Elsevier B.V. All rights reserved.