|Year/Author/Country||Purpose of Study||Sample||Types of Disease||Types of Outcomes and Measurements||Main Results|
|2009 Kearney et al. United Kingdom||To evaluate the impact of a mobile phone-based remote monitoring, advanced symptom management system (ASyMS©) on the incidence, severity and distress of six chemotherapy-related symptoms in patients with lung, breast, or colorectal cancer.||n = 112 (56 in each intervention or control group) patients from 7 clinical sites throughout the UK. Inclusion criteria: commencing a new course of chemotherapy treatment, receiving outpatient chemotherapy, age ≥ 18, written informed consent given, able to read and write English, and deemed by members of the clinical team as being physically and psychologically fit to participate in the study.||Chemotherapy related toxicity in patients with lung, breast, or colorectal cancer||
• Severity and distress of the six symptoms including vomiting, nausea, diarrhea, hand-foot syndrome, sore mouth/throat, and fatigue.|
• Incidence – (did symptom occur? Y/N), Severity and distress (scores 0–3) of the six individual symptoms.
• ASyMS has integrated the Common Toxicity Criteria Adverse Events (CTCAE) grading system and the Chemotherapy Symptom Assessment Scale.
• Paper version of the electronic symptom questionnaire was administrated at baseline, chemotherapy cycles 2, 3, 4, and 5 in both groups.
• Two of the six symptoms measured (fatigue and hand-foot syndrome) showed statistical significance between the control and intervention groups (respectively, p = 0.040, p = 0.031).|
• Patients reported improved communication with health professionals, improvements in the management of their symptoms, and feeling reassured their symptoms were being monitored while at home when using ASyMS.
|2013 Kristjánsdóttir et al. Norway||To study the long term effects of a 4-week smartphone intervention with diaries and therapist feedback following an inpatient chronic pain rehabilitation program (11-month follow up of 2013 Kristjánsdóttir et al. study)||n = 135 (intervention group: 69/control group: 66) Inclusion criteria: female, age ≥ 18, participating in the inpatient multidimensional rehabilitation programfor chronic pain, having chronic widespread pain > 6 months (with or without diagnosis of fibromyalgia), not participating in another research project at the rehab center, being able to use a smartphone, and not being diagnosed with a profound psychiatric disorder.||Chronic widespread pain or Fibromyalgia||
• Catastrophizing [Pain catastrophizing scale (PCS)]|
• Acceptance [Chronic pain acceptance questionnaire (CPAQ)]
• Emotional distress [modified General Health Questionnaire (GHQ)]
• Importance and success in living according to one’s own values in 6 domains (family, intimate relationships, friendship, work, health, and personal growth) [Chronic Pain Values Inventory (CPVI)]
• Pain, fatigue, sleep disturbance [Visual analog scales (VAS)]
• Impact of Fibromyalgia on functioning and symptom levels the past week [Fibromyalgia Impact Questionnaire (FIQ)]
• Functioning [Short-Form Health Survey (SF-8)]
• Use of noninteractive website [self-report at T3 (4 weeks after discharge)]
• Feasibility of the smartphone intervention (single question for post-intervention)
Short-term follow-up results:|
• Intervention group reported less catastrophizing (p < 0.001).
• Results from the per-protocol analysis indicate intervention with diaries and written personalized feedback reduced catastrophizing and increased acceptance and effects persisted 5 months after the intervention.
• Increased improvement in values-based living in the intervention group
• Control group showed an increased level of fatigue and a tendency toward an increase in sleep disturbance at the 5-month follow-up.
Long-term 11-month follow-up results:
• The between-group differences on catastrophizing, acceptance, functioning, and symptom level were no longer evident (p > 0.10).
• More improvement in catastrophizing scores during the follow-up period (T2-T5) in the intervention group (p = 0.045)
• Positive effect on acceptance was found within the intervention group (p < 0.001).
• Small to large negative effects were found within the control group on functioning and symptom levels, emotional distress, and fatigue (p = 0.05).
• Reduction in disease impact (measured by FIQ) found for intervention group (p = 0.03).
• Long-term results are ambiguous.
|2013 Garcia-Palacios et al. Spain||To compare compliance with paper diary vs. smartphone diary, aggregated ecological momentary assessment (EMA) data vs. retrospective data, and assess acceptability of EMA procedures.||n = 40 (intervention group:20/control group:20) Inclusion criteria: met criteria for FMS, defined by the American College of Rheumatology and were diagnosed by a rheumatologist.||Fibromyalgia syndrome (FMS)||
• EMA pain and fatigue (0–10 Numerical Rating Scales)|
• Mood (face-based pictorial 7-point scale)
• Weekly retrospective rating of pain and fatigue [Brief Pain Inventory (BPI) and Brief Fatigue Inventory (BFI)]
• Acceptability and preferences (self-report)
• Smartphone condition (smartphone diary) showed higher levels of compliance than paper condition (paper diary) (p < 0.01).|
• Retrospective assessment produces overestimation of events (pain and fatigue, p < 0.01).
• Smartphone condition preferred and accepted over paper diary, even in participants with low familiarity with technology.
|2014 Vuorinen et al. Finland||To study whether multidisciplinary care with telemonitoring leads to decreased HF-related hospitalization||n = 94 (intervention group: 47/control group: 47) Inclusion criteria: diagnosis of systolic heart failure, age 18–90 years, NYHA (New Work Heart Association) functional class ≥2, left ventricular ejection fraction ≤35%, need for a regular check-up visit, and time from the last visit of less than 6 months.||Heart failure (HF)||
• Number of HF-related hospital days (data from hospital electronic health record system)|
• Clinical effectiveness [death from any cause, heart transplant operation or listing for transplant operation, left ventricular ejection fraction (LVEF,%) measured by echocardiography, plasma concentration of N-terminal of the prohormone brain natriuretic peptide (NT-proBNP, ng/1), creatinine, sodium, and potassium]
• Self-care behavior (European Heart Failure Self-Care Behavior Scale)
• Use of health care resources (analyzed outpatient visits)
• No difference found in the number of HF-related hospital days (p = 0.351).|
• Intervention group used more health care resources.
• No statistically significant differences in patients’ clinical health status or self-care behavior.
|2015 Cingi et al. Turkey||To investigate the impact of a mobile patient engagement application on health outcomes and quality of life||n = 2282 interventions (physician on call patient engagement trial, POPET for patients with allergic rhinitis or asthma) POPET-AR (intervention group: 88/control group: 51) POPET-Asthma (intervention group: 60/control group:29)||Allergic rhinitis (AR) and asthma patients||• Health outcomes and quality of life [AR groups: Rhinitis Quality of Life Questionnaire (RQLQ), asthma groups: Asthma Control Test (ACT)]||
• POPET-AR group showed better clinical improvement than the control group in terms of overall RQLQ score as well in measures of general problems, activity, symptoms other than nose/eye, and emotion domains (p < 0.05).|
• More patients in the POPET-Asthma group achieved a well-controlled asthma score compared to the control group (p < 0.05).
|2015 Dicianno et al. United States||To determine feasibility of the interactive mobile health and rehabilitation (iMHere) system and its effects on psychosocial and medical outcomes||n = 23 (intervention group:13/control group:10) Inclusion criteria: age 18–40, primary diagnosis of myelomeningocele with hydrocephalus, ability to use smartphone, and living within 100 miles of testing site to allow for technical support.||Spina bifida (SB)||
• Usage (the number of participant responses to reminders, use of secure messaging, or photo uploads)|
• Physical independence (Craig Handicap Assessment and Reporting Technique Short Form, Physical independence domain)
• Self management skill (Adolescent Self-Management and Independence Scale II)
• Depressive symptoms (The Beck Depression Inventory-II)
• Perception of patient-centered care (Patient Assessment of Chronic Illness Care)
• Quality of Life (World Health Organization Quality of Life Brief Instrument)
• Number of UTIs (diagnosed UTIs)
• Number of wounds (unique skin breakdown episodes that were at least stage II)
• Number of emergency department (ED) visits (ED visits for any reason)
• Number of ED visits due to UTI or wound
• Number of planned and unplanned hospitalizations
• Number of hospitalizations due to UTI or wound
|• Smartphone system was found to be feasible and associated with short-term self-reported improvements in self-management skills.|
|2015 Hägglund et al. Sweden||To evaluate whether a home intervention system (HIS) using a tablet had an effect on self-care behavior.||n = 82 (intervention group:42/control group:40) Inclusion criteria: hospitalized and diagnosed for HF with reduced ejection fraction (HFrEF) and/or preserved EF (HFpEF), treatment with diuretics, and referred straight to primary care.||Heart failure (HF)||
• Disease-specific self-care (European Heart Failure Self-Care Behavior Scale)|
• Health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire)
• Adherence (frequency of HIS use)
• Knowledge (Dutch Heart Failure Knowledge Scale)
• HF-related hospital days (patients’ case books)
|• Intervention group showed improvement in self-care and HRQoL, reduction in HF-related hospital days.|
|2015 Martin et al. United States||To investigate whether a fully automated mHealth intervention with tracking and texting components increases physical activity.||n = 48 [unblinded = 32 (smart texts = 16, no texts = 16), blinded = 16] Unblinded participants were randomized to smart texts or no texts in phase II (weeks 4–5). Inclusion criteria: ages 18–69, using a Fitbug compatible smartphone (iPhone≥4S, Galaxy≥S3).||Cardiovascular disease (CVD)||
• Mean change in accelerometer-measured daily step count (measured by Fitbug Orb)|
• Attainment of prescribed 10,000 steps/day goal (measured by Fitbug Orb)
• Changes in total daily activity and aerobic time (measured by Fitbug Orb)
|• Intervention with texting component increased physical activity (p < 0.001).|
|2015 Piette et al. United States||To compare the effects of systematic feedback to HF patients’ caregivers and HF patients receiving standard mHealth.||n = 372 (intervention group:189/control group: 183) Inclusion criteria: HF diagnosis, ejection fraction < 40%, able to name eligible CarePartner (CP) that is a relative or friend living outside their home.||Heart failure (HF)||
• HF-related quality of life (Minnesota Living with Heart Failure Questionnaire)|
• Patient-CP communication (quantitative telephone surveys)
• Medication adherence and self-care (Revised Heart Failure Self-Care Behavior Scale)
• mHealth + CP (intervention) group showed improvement in medication adherence and caregiver communication.|
• mHealth + CP may improve qualify of life in patients with greater depressive symptoms and also decrease patients’ risk of shortness of breath and sudden weight gains.
|2016 Cubo et al. Spain||To evaluate the cost-effectiveness of home-based motor monitoring (HBMM) with in-office visits versus in-office visits alone in patients with advanced Parkinson’s disease||n = 40 (intervention group: 20/control group: 20) Inclusion criteria: non-demented outpatients from a tertiary regional movement disorders clinic, Mini-Mental Scale score > 24, and diagnosed with idiopathic, advanced PD.||Parkinson’s disease (PD)||
• Motor (Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr staging Scale) and non-motor (Non-Motor Symptoms Questionnaire Scale) symptom severities|
• Cost-effectiveness (incremental cost-effectiveness ratio)
• Direct costs (standardized questionnaire)
• Quality of life (EuroQoL)
• Neuropsychiatric symptoms (Hospital Anxiety Depression Scale, Scale for Evaluation of Neuropsychiatric Disorders, Parkinson Psychiatric Rating Scale)
• Comorbidities (Cumulative Illness Rating scale-Geriatric)
|• HBMM was found to be cost-effective in improvement of functional status, motor severity, and motor complications.|
|2016 DeVito Dabbs et al. United States||To compare the efficacy of an mHealth intervention in promoting self-management behaviors and self-care agency, rehospitalization, and mortality at home during the first year after lung transplantation.||n = 201 (intervention group: 99/control group: 102) Inclusion criteria: age > 18, received transplantation at the University of Pittsburgh Medical Center, and could read and speak English.||Lung transplant recipients (LTRs)||
• Self-monitoring (percentage of days that LTRs performed self-monitoring)|
• Adherence to regimen (Health Habits Survey)
• Critical health (percentage of critical indicators)
• Self-care agency (Perception of Self-Care Agency)
• Health outcomes (medical records)
• The intervention group performed self-monitoring (p < 0.001), adhered to medical regimen. (p = 0.046), and reported abnormal health indicators (p < 0.001) more frequently. Than the usual care group.|
• Both groups did not differ in re-hospitalization (p = 0.51) or mortality (p = 0.25).
|2016 Ginis et al. Israel and Belgium||To determine the feasibility and effectiveness of the gait training CuPiD-system for people with Parkinson’s disease in the home environment.||n = 40 (intervention group: 22/control group: 18) Inclusion criteria: ability to walk 0 min continuously, score of ≥24 on Montreal Cognitive Assessment, Hoehn and Yahr Stage II to III in ON-state, and on stable PD medication.||Parkinson’s disease (PD)||
• Single and dual task gait (gait speed)|
• Balance (mini-Balance Evaluation Systems Test, Four Square Step Test, Falls Efficacy Scale-International)
• Endurance and physical capacity (2 Minute Walk Test, Physical Activity Scale for the Elderly)
• Disease severity (Movement Disorders Unified Parkinson’s Disease Rating Scale – motor examination)
• Freezing of gait (New FOG Questionnaire, Ziegler protocol)
• Cognition (Color Trail Test A & B, sitting & walking verbal fluency) Quality of life (Short Form 36 Health Survey)
|The CuPiD-system was feasible and effective, as the intervention group improved significantly more on balance and maintained quality of life compared to the control group.|