title: The Effectiveness of Self-Management Mobile Phone and Tablet Apps in Long-term Condition Management: A Systematic Review.
abstract: BACKGROUND
  Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible.
  
  
  OBJECTIVE
  We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions.
  
  
  METHODS
  We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized controlled trials that assessed the effectiveness of mobile phone and tablet apps in self-management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 2005-2016. We searched registers of current and ongoing trials, as well as the gray literature. We then checked the reference lists of all primary studies and review papers for additional references. The last search was run in February 2016.
  
  
  RESULTS
  Of the 9 papers we reviewed, 6 of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised an app only, 3 studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). A total of 3 studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from 6 weeks to 1 year, and final follow-up data ranged from 3 months to 1 year. Sample size ranged from 48 to 288 participants.
  
  
  CONCLUSIONS
  The evidence indicates the potential of apps in improving symptom management through self-management interventions. The use of apps in mHealth has the potential to improve health outcomes among those living with chronic diseases through enhanced symptom control. Further innovation, optimization, and rigorous research around the potential of apps in mHealth technology will move the field toward the reality of improved health care delivery and outcomes.
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia. l.whitehead@ecu.edu.au.
authors.forename: Lisa
authors.identifier: http://orcid.org/0000-0002-6395-0279
authors.initials: L
authors.lastname: Whitehead
authors.forename: Philippa
authors.identifier: http://orcid.org/0000-0003-0136-4175
authors.initials: P
authors.lastname: Seaton
mesh_terms: D002318:Cardiovascular Diseases / Q000628:therapy; D040421:Cell Phone / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000628:therapy*; D003920:Diabetes Mellitus / Q000628:therapy; D019468:Disease Management; D006801:Humans; D008171:Lung Diseases / Q000628:therapy; D063731:Mobile Applications / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods*; D017216:Telemedicine / Q000379:methods*
keywords: apps; cardiovascular diseases; chronic disease; diabetes mellitus; lung diseases; mHealth; mobile phone; self-management; systematic review; telemedicine