Prescribable mHealth apps identified from an overview of systematic reviews

Abstract Mobile health apps aimed towards patients are an emerging field of mHealth. Their potential for improving self-management of chronic conditions is significant. Here, we propose a concept of “prescribable” mHealth apps, defined as apps that are currently available, proven effective, and pref...

Full description

Bibliographic Details
Main Authors: Oyungerel Byambasuren, Sharon Sanders, Elaine Beller, Paul Glasziou
Format: Article
Language:English
Published: Nature Portfolio 2018-05-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-018-0021-9
_version_ 1797428606315528192
author Oyungerel Byambasuren
Sharon Sanders
Elaine Beller
Paul Glasziou
author_facet Oyungerel Byambasuren
Sharon Sanders
Elaine Beller
Paul Glasziou
author_sort Oyungerel Byambasuren
collection DOAJ
description Abstract Mobile health apps aimed towards patients are an emerging field of mHealth. Their potential for improving self-management of chronic conditions is significant. Here, we propose a concept of “prescribable” mHealth apps, defined as apps that are currently available, proven effective, and preferably stand-alone, i.e., that do not require dedicated central servers and continuous monitoring by medical professionals. Our objectives were to conduct an overview of systematic reviews to identify such apps, assess the evidence of their effectiveness, and to determine the gaps and limitations in mHealth app research. We searched four databases from 2008 onwards and the Journal of Medical Internet Research for systematic reviews of randomized controlled trials (RCTs) of stand-alone health apps. We identified 6 systematic reviews including 23 RCTs evaluating 22 available apps that mostly addressed diabetes, mental health and obesity. Most trials were pilots with small sample size and of short duration. Risk of bias of the included reviews and trials was high. Eleven of the 23 trials showed a meaningful effect on health or surrogate outcomes attributable to apps. In conclusion, we identified only a small number of currently available stand-alone apps that have been evaluated in RCTs. The overall low quality of the evidence of effectiveness greatly limits the prescribability of health apps. mHealth apps need to be evaluated by more robust RCTs that report between-group differences before becoming prescribable. Systematic reviews should incorporate sensitivity analysis of trials with high risk of bias to better summarize the evidence, and should adhere to the relevant reporting guideline.
first_indexed 2024-03-09T09:00:17Z
format Article
id doaj.art-7d7a4610e8e44e80985a5424bc330ee2
institution Directory Open Access Journal
issn 2398-6352
language English
last_indexed 2024-03-09T09:00:17Z
publishDate 2018-05-01
publisher Nature Portfolio
record_format Article
series npj Digital Medicine
spelling doaj.art-7d7a4610e8e44e80985a5424bc330ee22023-12-02T11:45:55ZengNature Portfolionpj Digital Medicine2398-63522018-05-011111210.1038/s41746-018-0021-9Prescribable mHealth apps identified from an overview of systematic reviewsOyungerel Byambasuren0Sharon Sanders1Elaine Beller2Paul Glasziou3Centre for Research in Evidence-Based Practice (CREBP), Bond UniversityCentre for Research in Evidence-Based Practice (CREBP), Bond UniversityCentre for Research in Evidence-Based Practice (CREBP), Bond UniversityCentre for Research in Evidence-Based Practice (CREBP), Bond UniversityAbstract Mobile health apps aimed towards patients are an emerging field of mHealth. Their potential for improving self-management of chronic conditions is significant. Here, we propose a concept of “prescribable” mHealth apps, defined as apps that are currently available, proven effective, and preferably stand-alone, i.e., that do not require dedicated central servers and continuous monitoring by medical professionals. Our objectives were to conduct an overview of systematic reviews to identify such apps, assess the evidence of their effectiveness, and to determine the gaps and limitations in mHealth app research. We searched four databases from 2008 onwards and the Journal of Medical Internet Research for systematic reviews of randomized controlled trials (RCTs) of stand-alone health apps. We identified 6 systematic reviews including 23 RCTs evaluating 22 available apps that mostly addressed diabetes, mental health and obesity. Most trials were pilots with small sample size and of short duration. Risk of bias of the included reviews and trials was high. Eleven of the 23 trials showed a meaningful effect on health or surrogate outcomes attributable to apps. In conclusion, we identified only a small number of currently available stand-alone apps that have been evaluated in RCTs. The overall low quality of the evidence of effectiveness greatly limits the prescribability of health apps. mHealth apps need to be evaluated by more robust RCTs that report between-group differences before becoming prescribable. Systematic reviews should incorporate sensitivity analysis of trials with high risk of bias to better summarize the evidence, and should adhere to the relevant reporting guideline.https://doi.org/10.1038/s41746-018-0021-9
spellingShingle Oyungerel Byambasuren
Sharon Sanders
Elaine Beller
Paul Glasziou
Prescribable mHealth apps identified from an overview of systematic reviews
npj Digital Medicine
title Prescribable mHealth apps identified from an overview of systematic reviews
title_full Prescribable mHealth apps identified from an overview of systematic reviews
title_fullStr Prescribable mHealth apps identified from an overview of systematic reviews
title_full_unstemmed Prescribable mHealth apps identified from an overview of systematic reviews
title_short Prescribable mHealth apps identified from an overview of systematic reviews
title_sort prescribable mhealth apps identified from an overview of systematic reviews
url https://doi.org/10.1038/s41746-018-0021-9
work_keys_str_mv AT oyungerelbyambasuren prescribablemhealthappsidentifiedfromanoverviewofsystematicreviews
AT sharonsanders prescribablemhealthappsidentifiedfromanoverviewofsystematicreviews
AT elainebeller prescribablemhealthappsidentifiedfromanoverviewofsystematicreviews
AT paulglasziou prescribablemhealthappsidentifiedfromanoverviewofsystematicreviews