title: Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.
abstract: We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs.
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.). jpiette@umich.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.).
authors.forename: Justin
authors.initials: J
authors.lastname: List
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.).
authors.forename: Gurpreet K
authors.initials: GK
authors.lastname: Rana
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.).
authors.forename: Whitney
authors.initials: W
authors.lastname: Townsend
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.).
authors.forename: Dana
authors.initials: D
authors.lastname: Striplin
authors.affiliation: From Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI (J.D.P., D.S., M.H.); Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI (J.D.P., M.H.); Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI (J.L., M.H.): and Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI (G.K.R., W.T.).
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D000328:Adult; D020811:Biomedical Technology / Q000191:economics; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D040421:Cell Phone; D003906:Developing Countries; D048909:Diabetes Complications / Q000097:blood / Q000517:prevention & control; D019468:Disease Management; D015438:Health Behavior; D005102:Health Expenditures / Q000706:statistics & numerical data; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006280:Health Workforce / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D011203:Poverty; D040242:Risk Reduction Behavior; D012648:Self Care; D018581:Technology Transfer; D013675:Technology, High-Cost / Q000191:economics; D017216:Telemedicine / Q000191:economics / Q000295:instrumentation* / Q000706:statistics & numerical data
keywords: computational biology; developing countries; telemedicine