In many high-income countries, mobile phone subscriptions exceed the population, and in many low- and middle-income countries, this number is expanding faster than other infrastructures. Mobile phone usage has been rapidly increasing worldwide. Most studies were performed in high-income countries, implying that mHealth is still at an early stage of development in low-income countries. Exceptions include the moderate quality evidence of improvement in asthma patients, attendance rates, and increased smoking abstinence rates. For some fields, its impact is not evident, the results are mixed, or no long-term studies exist. In general, the methodological quality of the studies included in the systematic reviews is low. ![]() Studies also showed a positive impact of SMS reminders in improving attendance rates, with a similar impact to phone call reminders at reduced cost, and improved adherence to tuberculosis and human immunodeficiency virus therapy in some scenarios, with evidence of decrease of viral load.Ĭonclusions: Although mHealth is growing in popularity, the evidence for efficacy is still limited. A beneficial impact of mHealth was observed in chronic disease management, showing improvement in symptoms and peak flow variability in asthma patients, reducing hospitalizations and improving forced expiratory volume in 1 second improving chronic pulmonary diseases symptoms improving heart failure symptoms, reducing deaths and hospitalization improving glycemic control in diabetes patients improving blood pressure in hypertensive patients and reducing weight in overweight and obese patients. Ten reviews were rated as low quality (AMSTAR score 0-4), seven were rated as moderate quality (AMSTAR score 5-8), and six were categorized as high quality (AMSTAR score 9-11). The studies used diverse mHealth interventions, most frequently text messaging (short message service, SMS) applied to different purposes (reminder, alert, education, motivation, prevention). ![]() Seventeen reviews included studies performed in low- and middle-income countries. Of these, 23 systematic reviews (371 studies more than 79,665 patients) were included. ![]() Results: The searches resulted in a total of 10,689 articles. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist. Methods: We used a common search strategy of five major scientific databases, restricting the search by publication date, language, and parameters in methodology and content. Objective: We performed a systematic review of systematic reviews to assess the impact or effectiveness of mobile health (mHealth) interventions in different health conditions and in the processes of health care service delivery. mHealth could efficiently deliver high-quality health care, but the evidence supporting its current effectiveness is still mixed.
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