Heze Han1, Wei Guo1, Yifan Lu1, Miao Wang2. 1. Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 2. Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. Electronic address: wmiao@yeah.net.
Abstract
OBJECTIVES: Mobile applications (apps) facilitate aspects of people's lives and are useful auxiliary tools for controlling risk factors for chronic diseases. This meta-analysis and systematic review aimed to explore the effect of app-assisted interventions on blood pressure (BP) control in Chinese adults and summarize the common functions of these apps. STUDY DESIGN: This is a systematic review and meta-analysis. METHODS: The search was conducted in four databases (PubMed, Embase, China National Knowledge Infrastructure database, and China Biology Medicine database). The identified articles were reviewed independently by two researchers. A random-effects model was used to compute the effect size. Studies were assessed for risk of bias and the transparency and quality of the apps. RESULTS: Eighteen studies (n = 2965) were included in the final analysis. App-based interventions achieved additional decreases in BP levels (systolic BP [SBP]: -8.12 mmHg, 95% confidence interval [CI]: -11.47 to -4.77 mmHg, P < 0.001; diastolic BP [DBP]: -6.67 mmHg, 95% CI: -8.92 to -4.41 mmHg, P < 0.001). However, the results showed considerable heterogeneity (SBP: I2 = 97%, P < 0.001; DBP: I2 = 96%, P < 0.001). Four studies reported the BP control rate. The pooled results demonstrated a better control rate achieved via app-based interventions (risk ratio: 1.33; 95% CI: 1.18 to 1.49, P < 0.001) without heterogeneity (I2 = 0%). The transparency and replicability assessment revealed unsatisfying results, and only three studies reported more than half of the 16 items in the mHealth checklist. Few studies described the replicability, data security, and infrastructure of the apps used. We identified 16 app functions, with the top three functions being doctor-patient communication (16/16), health education (15/16), and personalized guidance (12/16). CONCLUSIONS: We showed app-based interventions had a positive effect on BP management in Chinese adults. However, there was high heterogeneity among the included studies, which merits further exploration when more standardized research has been conducted. The functions of the apps varied widely, and further development of apps for BP management should abide by appropriate reporting guidelines.
OBJECTIVES: Mobile applications (apps) facilitate aspects of people's lives and are useful auxiliary tools for controlling risk factors for chronic diseases. This meta-analysis and systematic review aimed to explore the effect of app-assisted interventions on blood pressure (BP) control in Chinese adults and summarize the common functions of these apps. STUDY DESIGN: This is a systematic review and meta-analysis. METHODS: The search was conducted in four databases (PubMed, Embase, China National Knowledge Infrastructure database, and China Biology Medicine database). The identified articles were reviewed independently by two researchers. A random-effects model was used to compute the effect size. Studies were assessed for risk of bias and the transparency and quality of the apps. RESULTS: Eighteen studies (n = 2965) were included in the final analysis. App-based interventions achieved additional decreases in BP levels (systolic BP [SBP]: -8.12 mmHg, 95% confidence interval [CI]: -11.47 to -4.77 mmHg, P < 0.001; diastolic BP [DBP]: -6.67 mmHg, 95% CI: -8.92 to -4.41 mmHg, P < 0.001). However, the results showed considerable heterogeneity (SBP: I2 = 97%, P < 0.001; DBP: I2 = 96%, P < 0.001). Four studies reported the BP control rate. The pooled results demonstrated a better control rate achieved via app-based interventions (risk ratio: 1.33; 95% CI: 1.18 to 1.49, P < 0.001) without heterogeneity (I2 = 0%). The transparency and replicability assessment revealed unsatisfying results, and only three studies reported more than half of the 16 items in the mHealth checklist. Few studies described the replicability, data security, and infrastructure of the apps used. We identified 16 app functions, with the top three functions being doctor-patient communication (16/16), health education (15/16), and personalized guidance (12/16). CONCLUSIONS: We showed app-based interventions had a positive effect on BP management in Chinese adults. However, there was high heterogeneity among the included studies, which merits further exploration when more standardized research has been conducted. The functions of the apps varied widely, and further development of apps for BP management should abide by appropriate reporting guidelines.