Efficacy of mobile applications to support the care of patients with diabetes mellitus : systematic review and meta-analysis

Bonoto, Bráulio Cezar and de Araújo, Vânia Eloisa and Godói, Isabella Piassi and Pires Lemos, Livia Lovato and Godman, Brian and Bennie, Marion and Diniz, Leonardo Mauricio and Guerra Júnior, Augusto Afonso (2017) Efficacy of mobile applications to support the care of patients with diabetes mellitus : systematic review and meta-analysis. JMIR mHealth and uHealth, 5 (3). e4. ISSN 2291-5222 (https://doi.org/10.2196/mhealth.6309)

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Abstract

Background- Diabetes Mellitus (DM) is a chronic disease that is considered a global public health problem. Education and self-monitoring by diabetic patients help to optimize and make possible a satisfactory metabolic control enabling improved management and reduced morbidity and mortality. The global growth in the use of mobile phones makes them a powerful platform to help provide tailored health, delivered conveniently to patients through health applications (apps). Objective- Evaluate the efficacy of mobile apps through a systematic review and meta-analysis to assist diabetes mellitus patients in treatment. Methods- We conducted searches in the electronic databases MEDLINE (Pubmed), CENTRAL/ Cochrane Register of Controlled Trials and LILACS, manual search in references of publications included, systematic reviews, specialized journals and gray literature. We considered eligible randomized controlled trials (RCTs) conducted after 2008 with participants of all ages, diabetes mellitus patients and users of apps to help manage the disease. The meta-analysis of glycated hemoglobin (HbA1c) was performed in Review Manager Software 5.3. Results- The literature search identified 1236 publications. From these, 13 studies were included that evaluated 1263 patients. In six RCTs, there were a statistical significant reduction (P < 0.05) of HbA1c at the end of studies in the intervention group. The HbA1c data were evaluated by meta-analysis with the following results (MD = - .44; CI: - .59, - .29; P < .10; I² = 32%).The evaluation favored the treatment in patients who used apps without significant heterogeneity. Conclusions - The use of apps by diabetic patients could help improve the control of HbA1c. In addition, the apps seem to strengthen the perception of self-care contributing better information and health education to patients. Patients also become more self-confident to deal with their diabetes, mainly, by reducing fear of not knowing how to deal with potential hypoglycemic episodes that may occur.

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