There is potential for mHealth tools to better facilitate adherence to chronic disease management , but the evidence supporting its current effectiveness is mixed .
BACKGROUND Adherence to chronic disease management is critical to achieving improved health outcomes , quality of life , and cost-effective health care .
As the burden of chronic diseases continues to grow globally , so does the impact of non-adherence .
Mobile technologies are increasingly being used in health care and public health practice ( mHealth ) for patient communication , monitoring , and education , and to facilitate adherence to chronic diseases management .
OBJECTIVE We conducted a systematic review of the literature to evaluate the effectiveness of mHealth in supporting the adherence of patients to chronic diseases management ( " mAdherence " ) , and the usability , feasibility , and acceptability of mAdherence tools and platforms in chronic disease management among patients and health care providers .
Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes
Background Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team . “ Sweet Talk ” is a novel intervention design ed to support patients between clinic visits using text messages sent to a mobile phone . Scheduled messages are tailored to patient profiles and diabetes self-management goals , and generic messages include topical “ newsletters ” and anonymized tips from other participants . The system also allows patients to su bmi t data and questions to the diabetes care team . Objectives The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to underst and its utility to this user group . Methods Subjects were 64 young people with diabetes who were participating in the intervention arms of a r and omized controlled trial . All text messages su bmi tted to Sweet Talk during a 12-month period were recorded . Messaging patterns and content were analyzed using mixed quantitative and qualitative methods . Results Patients su bmi tted 1180 messages during the observation period ( mean 18.4 , median 6 ) . Messaging frequency ranged widely between participants ( 0 - 240 ) with a subset of 5 high users contributing 52 % of the total . Patients ’ clinical and sociodemographic characteristics were not associated with total messaging frequency , although girls sent significantly more messages unrelated to diabetes than did boys ( P = .002 ) . The content of patients ’ messages fell into 8 main categories : blood glucose readings , diabetes questions , diabetes information , personal health administration , social messages , technical messages , message errors , and message responses . Unprompted su bmi ssion of blood glucose values was the most frequent incoming message type ( 35 % of total ) . Responses to requests for personal experiences and tips generated 40 % of all the incoming messages , while topical news items also generated good responses . Patients also used the service to ask questions , su bmi t information about their self-management , and order supplies . No patients nominated supporters to receive text messages about their self-management goals . Another option that was not used was the birthday reminder service . Conclusions Automated , scheduled text messaging successfully engaged young people with diabetes . While the system was primarily design ed to provide “ push ” support to patients , su bmi ssion of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers . Responses to the newsletters and su bmi ssion of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community . Although participants su bmi tted relatively few messages , positive responses to the system suggest that most derived passive support from reading the messages . The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups , and the results of this study may help to inform the design of future text message support interventions
There is potential for mHealth tools to better facilitate adherence to chronic disease management , but the evidence supporting its current effectiveness is mixed .
BACKGROUND Adherence to chronic disease management is critical to achieving improved health outcomes , quality of life , and cost-effective health care .
As the burden of chronic diseases continues to grow globally , so does the impact of non-adherence .
Mobile technologies are increasingly being used in health care and public health practice ( mHealth ) for patient communication , monitoring , and education , and to facilitate adherence to chronic diseases management .
OBJECTIVE We conducted a systematic review of the literature to evaluate the effectiveness of mHealth in supporting the adherence of patients to chronic diseases management ( " mAdherence " ) , and the usability , feasibility , and acceptability of mAdherence tools and platforms in chronic disease management among patients and health care providers .