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MHealth Solutions for Type2 Diabetes
According to WHO (2008), mHealth can be defined as mobile computing, medical sensor, and communication technologies for health care. mHealth employs various features, including SMS text messages, emails, phone calls, and mobile phone apps. Therefore, this technology’s potential use is evident, both for the general population and clinical samples, since it is employed to improve healthy behaviors and self-care in many medical conditions.
In diabetes, multiple mHealth solutions were produced and implemented for self-management behaviors. However, little research on the effectiveness of psychological techniques implemented within these mHealth solutions was carried out and even less with the elderly population where technological barriers might exist. Reliable evidence generated through a comprehensive evaluation of mHealth interventions may accelerate its growth for successful long-term implementation and to help to experience mHealth benefits in an enhanced way in all ages. This study aimed to review mHealth solutions for diabetes self-management in older adults (focusing on adherence to treatments and glycemic control) by analyzing the effectiveness of specific psychological techniques implemented. For these purposes, a narrative review was conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed (Medline) and American Psychological Association (APA) PsycInfo databases were searched for published papers that addressed eHealth solutions’ effectiveness for diabetes self-management. Studies in English, Spanish, and/or German of any design were screened, with no time constraints regarding the year of publication. A qualitative analysis of the selected papers was conducted in several steps. This review found 38 studies setting up and analyzing mHealth solutions for older adults. Most research showed improvements in HbA1c, self-management behaviors, and medication adherence in T2DM patients post-intervention. However, different mid-to-long term effects were found across studies, specifically concerning the maintenance and adherence to healthy behaviors. The most employed psychological framework was CBT, including techniques such as self-monitoring of outcome behaviors (mostly targeting glycemia measurements and healthy habits as physical activity and/or diet), tailored motivational feedback from medical staff, and psychoeducation or health coaches. The most successful mHealth intervention combined the feature of tailored feedback messages, interactive communication with healthcare professionals, and multifaceted functions. To conclude, there is a lack of elaborate and detailed information in the literature regarding the factors considered in the design and development of mHealth solutions used as interventions for T2DM self-management in the elderly. Documentation and inclusion of such vital information will foster a transparent and shared decision-making process that will ultimately lead to the development of useful and user-friendly self-management apps that can enhance the quality of life for diabetes patients. Further research adapting mHealth solutions to older adults’ sensory deficits is necessary.
3. Implications for policy making and future research
Effective treatment of T2DM requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mHealth–based self-management became a useful treatment for T2DM, and its effectiveness was assessed in many trials. However, there is a paucity of comprehensive summaries of the studies carried out with the older adults’ population and testing mHealth solutions with a solid psychological framework supporting techniques embedded in the app.
The entry is from 10.3390/jcm10122701
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