Diabetes type 1 (DT1) patient adherence and empowerment is needed to accomplish with self-management education to prevent acute complications and more importantly long term. The use of the smartphone has skyrocketed in all groups,providing a more accessible platforms to improve clinical outcomes and non-clinical through digital interventions. Although many reviews have proven clear evidence of the contribution of mHealth in diabetes management,specifically,DT1,further research needs to be undertaken. The main objective of this scoping review is to analysis evidence-based features and outcomes that demonstrate positive effects and improvements in self-management of DT1 patients due to educational interventions in mobile health applications.
We conducted a review of literature published since 1999 in Pubmed database following Joanna Briggs methodology using key search terms:mobile app for diabetes,behavioral change,DT1.
We identified total of 88 articles through database searching. After the screening, we included 23 descriptive supporting studies in the scoping review targeting DT1, eligible for analysis. Most of the studies reported positive outcomes after use of mobile health applications with slightly improvement of clinical outcomes:HbA1c(66%), blood pressure(12%) and triglycerides(9%). The most prevalent features in mHealth were (1)monitoring blood glucose level and insulin, (2)nutrition,(3)physical exercise,(4)body weight,(5)appointments management,(6)social media and (7)interactive feedback. Although clinical guidelines widely refer to the importance of motivation and activation, personalized empowerment features should be included in apps for assessment of potential in the self-management.
The evidence indicates the potential of mHealth apps to improve health outcomes. However, these digital solutions must be designed integrating evidence-based behavioral change theoretical foundations to proof effectiveness.