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首页> 外文期刊>JMIR mHealth and uHealth >The Impact of mHealth Interventions: Systematic Review of Systematic Reviews
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The Impact of mHealth Interventions: Systematic Review of Systematic Reviews

机译：mHealth干预的影响：系统评价的系统评价

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Background Mobile phone usage has been rapidly increasing worldwide. mHealth could efficiently deliver high-quality health care, but the evidence supporting its current effectiveness is still mixed. Objective We performed a systematic review of systematic reviews to assess the impact or effectiveness of mobile health (mHealth) interventions in different health conditions and in the processes of health care service delivery. Methods We used a common search strategy of five major scientific databases, restricting the search by publication date, language, and parameters in methodology and content. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist. Results The searches resulted in a total of 10,689 articles. Of these, 23 systematic reviews (371 studies; more than 79,665 patients) were included. Seventeen reviews included studies performed in low- and middle-income countries. The studies used diverse mHealth interventions, most frequently text messaging (short message service, SMS) applied to different purposes (reminder, alert, education, motivation, prevention). Ten reviews were rated as low quality (AMSTAR score 0-4), seven were rated as moderate quality (AMSTAR score 5-8), and six were categorized as high quality (AMSTAR score 9-11). A beneficial impact of mHealth was observed in chronic disease management, showing improvement in symptoms and peak flow variability in asthma patients, reducing hospitalizations and improving forced expiratory volume in 1 second; improving chronic pulmonary diseases symptoms; improving heart failure symptoms, reducing deaths and hospitalization; improving glycemic control in diabetes patients; improving blood pressure in hypertensive patients; and reducing weight in overweight and obese patients. Studies also showed a positive impact of SMS reminders in improving attendance rates, with a similar impact to phone call reminders at reduced cost, and improved adherence to tuberculosis and human immunodeficiency virus therapy in some scenarios, with evidence of decrease of viral load. Conclusions Although mHealth is growing in popularity, the evidence for efficacy is still limited. In general, the methodological quality of the studies included in the systematic reviews is low. For some fields, its impact is not evident, the results are mixed, or no long-term studies exist. Exceptions include the moderate quality evidence of improvement in asthma patients, attendance rates, and increased smoking abstinence rates. Most studies were performed in high-income countries, implying that mHealth is still at an early stage of development in low-income countries.
机译：背景技术移动电话的使用在世界范围内迅速增加。 mHealth可以有效地提供高质量的医疗保健，但是支持其当前有效性的证据仍然参差不齐。目的我们对系统评价进行了系统评价，以评估移动健康（mHealth）干预措施在不同健康状况以及医疗服务提供过程中的影响或有效性。方法我们使用了五个主要科学数据库的通用搜索策略，通过出版日期，语言以及方法和内容中的参数来限制搜索。使用评估工具评估系统评价（AMSTAR）清单评估方法学质量。结果搜索结果共计10,689篇文章。其中，包括23项系统评价（371项研究;超过79,665例患者）。 17条评论包括在中低收入国家进行的研究。这些研究使用了多种mHealth干预措施，最常见的是将短信（短信服务，SMS）应用于不同的目的（提醒，警报，教育，动机，预防）。有10条评论被评为低质量（AMSTAR得分0-4），有7条被评为中等质量（AMSTAR得分5-8），有6条被归类为高质量（AMSTAR得分9-11）。在慢性疾病管理中观察到了mHealth的有益​​影响，显示出哮喘患者的症状和峰值流量变异性得到改善，住院时间减少，并且在1秒内改善了呼气量;改善慢性肺部疾病症状;改善心力衰竭症状，减少死亡和住院;改善糖尿病患者的血糖控制;改善高血压患者的血压;并减轻超重和肥胖患者的体重。研究还显示，短信提醒对提高出勤率具有积极影响，与电话提醒具有相似的影响，且费用降低，并且在某些情况下提高了对结核病和人类免疫缺陷病毒治疗的依从性，并有病毒载量减少的迹象。结论尽管mHealth越来越流行，但有效性的证据仍然有限。通常，系统评价中包括的研究方法学质量较低。对于某些领域，其影响不明显，结果参差不齐，或者不存在长期研究。例外情况包括哮喘患者病情好转，出勤率和戒烟率提高的中等质量证据。大多数研究是在高收入国家进行的，这意味着低收入国家的mHealth仍处于发展的早期阶段。

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