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Table 3 Details of mobile application intervention for chronic disease management

From: Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review

Study

Length of Intervention

Name of Mobile Application and Platform

Program of Intervention

Delivery of Intervention (Training of mHealth)

2009 Kearney et al. United Kingdom

Five time pointes (baseline, chemotherapy cycle 2, 3, 4, and; each cycle has up to 14 days).

Advanced symptom management system (ASyMS©)

• A mobile phone-based remote monitoring and reporting of chemotherapy-related toxicity.

• Participants completed the electronic symptom questionnaire on their mobile phone, took their temperature using an electronic thermometer and entered the value into the application twice a day for 2 weeks after their first 4 cycles of chemotherapy

• Patients received tailored self-care advice on their mobile phone based on the severity of symptoms reported

Patients were trained on how to use the system by nurses working in their local clinic who had received training by the study team on how to use the system.

2013 Kristjánsdóttir et al. Norway

4 weeks

Application: Diaries and Daily Situational Feedback Smartphone: HTC TyTN (touchscreen and keyboard)

• The intervention consisted of 4 components: face-to-face session – 1 h individual session with nurse, web-based diaries – 3 diary entries/day using the smartphone, written situational feedback – daily written feedback from therapist on information provided in diary, and audio files – 4 mindfulness exercises guided by the authors

• All participants received access to a non-interactive website with information on self-management strategies for people with chronic pain

• Self-reported assessments on paper were gathered before (T1) and after (T2) the inpatient program, immediately after the smartphone intervention which was 4 weeks after discharge (T3), and 5 (T4) and 11 months (T5) after the smartphone intervention

Patients attended an informational group meeting. Participants were lent smartphones and received information about their therapist for the intervention during the face-to-face session.

2013 Garcia-Palacios et al. Spain

2 weeks

Software application: F-EMA (ecological momentary assessment) Smartphone: HTC Diamond 1 (TOUCH Diamond 1, HTC Corporation, New Taipei City, Taiwan) Software: Windows Mobile 6.1

• Session 1 (7 days): participants were randomly assigned a self-record condition and recorded their pain, fatigue, and mood 3 times/day

• Session 2 (7 days): acceptability questionnaire and Brief Pain Inventory (BPI) and Brief Fatigue inventory (BFI) were administered regarding the first condition, and participants received the other self-record condition

• Session 3: acceptability questionnaire, BPI and BFI, and preference questionnaire were administered regarding the second condition

Participants attended an individual information session during the first week. They were given verbal instructions on the self-record method, explanations of the scales, and practiced rating the scales with the researcher. An information sheet with definitions of each scale and instructions for the self-recording were given to each patient.

2014 Vuorinen et al. Finland

6 months

Application name not available. Application enabled recording of all necessary measurements and symptoms.

• Patient made measurements (blood pressure, pulse, and body weight), assessed symptoms (dizziness, dyspnea, palpitation, weakness, and edema), and evaluated overall condition (deteriorated, improved, or remained unchanged) once a week

• Patient received automatic machine-based feedback of whether parameter was within personal targets set by nurse

• Nurse contacted patient each time measurement was beyond target levels

Patients given a home-care package: weight scale, blood pressure meter, mobile phone, and self-care instructions.

2015 Cingi et al. Turkey

1 month (patients with allergic rhinitis(AR)), 3 months (asthma patients)

Application: physician on call patient engagement trial (POPET-AR; POPET-Asthma)

• The application allowed patients to communicate with their physician, record their health status and medication compliance

• Provided motivational and educational content

• Reminded patients to take prescribed medications

Patients were educated on the recommended use of prescribed medications and informed about the Rhinitis Quality of Life Questionnaire and the Asthma Control Test. Trial information, application training, and technical support was available online.

2015 Dicianno et al. United States

12 months

Application: iMHere Smartphone: Android Provided participants with a phone plan that included unlimited texting and data.

• Intervention consisted of 6 modules, a web-based clinician portal, and a 2-way communication system

• Modules served as reminders to perform various self-care tasks, record wounds, manage medications, complete mood surveys, and for secure messaging

• Patient problems were triaged on a web-based dashboard for physicians

Participants were instructed to use the modules based on their own prescribed protocols.

2015 Hagglund et al. Sweden

3 months

Application: HIS: OPTILOGG Tablet wirelessly connected to weight scale.

• HIS monitored weight and symptoms, titrated diuretics, and provided information about HF and lifestyle advice

Intervention group received a basal information sheet. The HIS was installed in their home.

2015 Martin et al. United States

5 weeks

Smartphone application: Fitbug Digital physical activity tracker: Fitbug Orb Smartphone texting system: Reify

• Automated mHealth intervention with tracking and texting components

• Unblinded participants could view their daily step count, activity time, and aerobic activity time through smartphone and web interfaces; blinded participants were unable to view this information

• Smart texts delivered coaching 3 times/day aimed at individual encouragement and fostering feedback loops by an automated, physician written, theory-based algorithm with a goal of 10,00 steps/day

No training mentioned.

2015 Piette et al. United States

12 months

mHealth application was not mentioned. Intervention used interactive voice response (IVR) telephone calls.

• Standard mHealth group received weekly interactive voice response (IVR) calls with tailored self-management advice

• mHealth + CarePartner (CP) group received the same intervention but with automated emails sent to their CP after each IVR call with feedback about the heart failure (HF) patient’s status and suggestions to support disease care

• CP called their patient-partner weekly to review reports and address identified problems

Both groups were mailed information about HF self-care. CPs received guidelines about how to communicate in a positive motivating way, avoid conflict by respecting boundaries, include in-home caregivers, and respect confidentiality.

2016 Cubo et al. Spain

12 months

System: Kinesia, included tablet software app, wireless finger-worn motion sensor unit, and automated web-based symptom reporting.

• All patients with Parkinson’s disease (PD) completed structured questionnaires and were assessed under the beneficial effect of the antiparkinsonian drugs in the clinic every 4 months following the same protocol

• PD motor symptoms were monitored at home 1 day/month with 3–6 motor assessments and a structured questionnaire in the HBMM group

Assistant brought Kinesia device and provided training in each participant’s home.

2016 DeVito Dabbs et al. United States

12 months

Program: Pocket Personal Assistant for Tracking Health (Pocket PATH)

• Participants recorded daily health indicators, viewed graphical displays of trends, and received automatic feedback messages when reaching critical threshold values using the Pocket PATH system

Patients received scripted discharge instructions from an interventionist and an instruction binder emphasizing the importance of performing daily self-management behaviors at home in 60 min training sessions.

2016 Ginis et al. Israel and Belgium

6 weeks

CuPiD-system: smartphone (Galaxy S3-mini, Samsung, South Korea), docking station, 2 inertial measurement units (EXLs3, EXEL srl., Italy), and 2 applications (the audio-bio feedback, ABF-gait app, the instrumented cueing for freezing of gait, FOG-cue app)

• The CuPiD-system measured gait in real-time, provided positive and corrective auditory biofeedback (ABF) on gait parameters, and rhythmical auditory cueing to prevent or overcome freezing of gait (FOG) episodes

Researchers provided gait training to CuPiD participants for 30 min, 3 times/week for 6 weeks. Participants with FOG were taught ways to avoid FOG and practiced for an additional 30 min, 3 times/week using the FOG-cue app. Pictures and personalized instructions were also given to participants. Telephone consultation was available for system support.