Mobile health devices used to support a complaint lifestyle in patients with chronic diseases: a systematic review
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Date
2018-10
Authors
Van der Walt, Lezelle Ruanda
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Increased urbanisation and the unhealthy habits individuals adopt have caused chronic diseases to approach endemic proportions; chronic diseases play the dominant role in mortality globally. Mobile devices can be used to support compliant lifestyles in patients with chronic diseases by helping patients with chronic diseases control their symptoms and manage their treatment, thereby ensuring self-efficacy. The purpose of the study was to present a critical synthesis of the best evidence, published between 2012 and 2018, that mobile health devices can support a compliant lifestyles in patients with chronic diseases. The research design was a systematic review. A focused review question was compiled based on the PICO principle (Population, Intervention, Comparison intervention and Outcome), and the PICO format directed the review process. Several search methods and databases were utilised to find relevant studies applicable to the review question. The systematic search identified 1 106 studies, though only 27 studies were selected for critical appraisal after the filtering process. Standardised critical appraisal tools were used by three researchers to critically appraise the selected studies during round-table discussions, after which eight of the 27 studies were excluded, and 19 studies were found to be methodologically sufficient for analysis. The 19 studies comprised 15 randomised controlled trials, two systematic reviews, one qualitative review and one survey. After the analysis, the following concluding statements were formulated in relation to the review question. The researcher also provided recommendations. Concluding statement 1:Cell phones were used to support compliant lifestyles for patients with various chronic diseases, and had positive results. Concluding statement 2:Messages addressing specific information, such as lifestyle changes, reminders, self-monitoring and education, were communicated to patients with chronic diseases, and had positive results in managing chronic diseases. Concluding statement 3: Frequency of messages varied in the synthesised studies, from 24 hours a day to 3 times monthly having positive outcomes and effectively managing patients’ chronic diseases. Concluding statement 4: Messages originated from researchers, healthcare workers, automated messages and a centralised server and accomplished effective management of the chronic disease. Concluding statement 5: Positive outcomes were achieved regardless of the varied intervention periods, which lasted from 4 weeks to 3 years. Concluding statement 6:Compliant lifestyle was evident in all the synthesised studies, as a result of the intervention, although some results measured showed a small impact. Self-efficacy was evident is all synthesised studies, with improvement in chronic disease management. The researcher made several recommendations. Upon concluding that compliant lifestyles were evident in patients with chronic diseases who were being supported via mobile health devices, the accessibility of this technology should be investigated and infrastructure should be developed to manage chronic diseases better. Second, messages should be adapted according to the conditions and needs of the patients concerned. Patients should be provided with the tools to self-monitor their symptoms and receive support from the staff to manage the symptoms. Third, researchers should consider the frequency of the information needed by patients, and adapt the frequency of messages according to the needs of patients. Another recommendation relates to the necessity of training the staff involved in interventions thoroughly in relation to using mobile technology for interventions. The study recommends that researchers determine the best intervention period to achieve the best results, considering patients’ knowledge of the intervention and mobile devices. More studies are needed to determine which components in the study rendered positive results, and what can be discarded or be improved. The thorough synthesis of the studies included in the research created new information and added great value to future research. This study can form part of the theoretical underpinning of the development of mobile health applications for supporting patients with chronic diseases.
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Keywords
Dissertation (M.Soc.Sc. (Nursing))--University of the Free State, 2018, Chronic disease, Compliant lifestyle, Mobile devices, Systematic review