TY - JOUR
T1 - Assessing the Effectiveness of mHealth Interventions for Diabetes and Hypertension Management in Africa
T2 - Systematic Review and Meta-Analysis
AU - Aovare, Pearl
AU - Abdulai, Kasim
AU - Laar, Amos
AU - van der Linden, Eva L.
AU - Moens, Nicolaas
AU - Richard, Edo
AU - Moll van Charante, Eric P.
AU - Agyemang, Charles
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Background: Mobile health (mHealth) interventions are effective in improving chronic disease management, mainly in high-income countries. However, less is known about the efficacy of mHealth interventions for the reduction of cardiovascular risk factors, including for hypertension and diabetes, which are rapidly increasing in low- and middle-income countries. Objective: This study aimed to assess the efficacy of mHealth interventions for diabetes and hypertension management in Africa. Methods: We searched PubMed, Cochrane Library, Google Scholar, African Journals Online, and Web of Science for relevant studies published from inception to July 2022. The main outcomes of interest were changes in hemoglobin A1c (HbA1c), systolic blood pressure, and diastolic blood pressure. The random or fixed effect model was used for the meta-analysis, and the I2 statistic was used to gauge study heterogeneity. Z tests and P values were used to evaluate the effect of mHealth interventions on HbA1c and blood pressure levels. Results: This review included 7 studies (randomized controlled trials) with a total of 2249 participants. Two studies assessed the effect of mHealth on glycemic control, and 5 studies assessed the effect of mHealth on blood pressure control. The use of mHealth interventions was not associated with significant reductions in HbA1c levels (weighted mean difference [WMD] 0.20, 95% CI −0.40 to 0.80; P=.51) among patients with diabetes and systolic blood pressure (WMD −1.39, 95% CI −4.46 to 1.68; P=.37) and diastolic blood pressure (WMD 0.36, 95% CI −1.37 to 2.05; P=.69) among patients with hypertension. After conducting sensitivity analyses using the leave-one-out method, the Kingue et al study had an impact on the intervention, resulting in a 2 mm Hg reduction in systolic blood pressure (WMD −2.22, 95% CI −3.94 to −0.60; P=.01) but was nonsignificant for diastolic blood pressure and HbA1c levels after omitting the study. Conclusions: Our review provided no conclusive evidence for the effectiveness of mHealth interventions in reducing blood pressure and glycemic control in Africa among persons with diabetes and hypertension. To confirm these findings, larger randomized controlled trials are required.
AB - Background: Mobile health (mHealth) interventions are effective in improving chronic disease management, mainly in high-income countries. However, less is known about the efficacy of mHealth interventions for the reduction of cardiovascular risk factors, including for hypertension and diabetes, which are rapidly increasing in low- and middle-income countries. Objective: This study aimed to assess the efficacy of mHealth interventions for diabetes and hypertension management in Africa. Methods: We searched PubMed, Cochrane Library, Google Scholar, African Journals Online, and Web of Science for relevant studies published from inception to July 2022. The main outcomes of interest were changes in hemoglobin A1c (HbA1c), systolic blood pressure, and diastolic blood pressure. The random or fixed effect model was used for the meta-analysis, and the I2 statistic was used to gauge study heterogeneity. Z tests and P values were used to evaluate the effect of mHealth interventions on HbA1c and blood pressure levels. Results: This review included 7 studies (randomized controlled trials) with a total of 2249 participants. Two studies assessed the effect of mHealth on glycemic control, and 5 studies assessed the effect of mHealth on blood pressure control. The use of mHealth interventions was not associated with significant reductions in HbA1c levels (weighted mean difference [WMD] 0.20, 95% CI −0.40 to 0.80; P=.51) among patients with diabetes and systolic blood pressure (WMD −1.39, 95% CI −4.46 to 1.68; P=.37) and diastolic blood pressure (WMD 0.36, 95% CI −1.37 to 2.05; P=.69) among patients with hypertension. After conducting sensitivity analyses using the leave-one-out method, the Kingue et al study had an impact on the intervention, resulting in a 2 mm Hg reduction in systolic blood pressure (WMD −2.22, 95% CI −3.94 to −0.60; P=.01) but was nonsignificant for diastolic blood pressure and HbA1c levels after omitting the study. Conclusions: Our review provided no conclusive evidence for the effectiveness of mHealth interventions in reducing blood pressure and glycemic control in Africa among persons with diabetes and hypertension. To confirm these findings, larger randomized controlled trials are required.
KW - Africa
KW - blood pressure
KW - blood sugar
KW - chronic disease
KW - diabetes
KW - effectiveness
KW - efficiency
KW - glycemic
KW - hypertension
KW - intervention
KW - interventions
KW - mHealth
KW - management
KW - mobile health
KW - resource
UR - http://www.scopus.com/inward/record.url?scp=85168982381&partnerID=8YFLogxK
U2 - 10.2196/43742
DO - 10.2196/43742
M3 - Article
C2 - 37646291
AN - SCOPUS:85168982381
SN - 2291-5222
VL - 11
JO - JMIR mHealth and uHealth
JF - JMIR mHealth and uHealth
M1 - e43742
ER -
