Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

Cho E, et al. J Korean Acad Nurs. 2011 Jun;41(3):325-332. http://dx.doi.org/10.4040/jkan.2011.41.3.325

Choi M, et al. Healthc Inform Res. 2012 Sep;18(3):191-198. http://dx.doi.org/10.4258/hir.2012.18.3.191

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Ecological momentary assessment (EMA) has utility for measuring psychological properties in daily life. Recently, EMA has also allowed researchers to collect data on diverse experiences and symptoms from various subjects. Objective: To review the methodological details and usefulness of EMA using mobile phone applications to measure mood and stress in subclinical subjects. Methods: We searched PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. This review included studies published in peer-reviewed journals in English between 2008 and November 2017 that used mobile phone applications to measure momentary mood or stress in adults. We excluded studies using ecological momentary interventions (EMIs), studies of smoking, addictions, major psychological populations, and studies measuring non-clinical variables for non-clinical subjects. Results: : We reviewed nine selected articles that used EMA via mobile applications to measure momentary mood and stress, and other related variables from various subjects, such as patients with chronic fatigue syndrome, breast cancer, migraine, HIV, depressed mood during pregnancy, and adults with mood changes. Most of the selected studies used signal-contingent at random or semi-random intervals to prompt the momentary measurement. Seven of nine studies used specific applications directly installed on mobile phones and the remainder used mobile phones to link to web-based survey programs. Conclusions: The current study provides researchers with useful information regarding methodological details for utilizing EMA to measure mood and stress. This review shows that EMA methods could be effective and reasonable for measuring momentary mood and stress, given that smartphones are ubiquitous in the general population. Therefore, researchers could adopt and utilize EMA methods to measure psychological health outcomes, such as mood and stress, in subclinical populations.