The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review
Open accessAbstract
Introduction: Rates of chronic diseases will continue to rise in developing countries unless effective and cost-effective interventions are implemented. This review aims to discuss the impact of mobile health (m-health) on chronic disease outcomes in low- and middle-income countries (LMIC). Materials and Methods: Systematic literature searches were performed using CENTRAL, MEDLINE, EMBASE, and LILACS databases and gray literature. Scientific literature was searched to identify controlled studies evaluating cell phone voice and text message interventions to address chronic diseases in adults in low- or middle-income countries. Outcomes measured included morbidity, mortality, hospitalization rates, behavioral or lifestyle changes, process of care improvements, clinical outcomes, costs, patient–provider satisfaction, compliance, and health-related quality of life (HRQoL). Results: From the 1,709 abstracts retrieved, 163 articles were selected for full text review, including 9 randomized controlled trials with 4,604 participants. Most of the studies addressed more than one outcome. Of the articles selected, six studied clinical outcomes, six studied processes of care, three examined healthcare costs, and two examined HRQoL. M-health positively impacted on chronic disease outcomes, improving attendance rates, clinical outcomes, and HRQoL, and was cost-effective. Conclusions: M-health is emerging as a promising tool to address access, coverage, and equity gaps in developing countries and low-resource settings. The results for m-health interventions showed a positive impact on chronic diseases in LMIC. However, a limiting factor of this review was the relatively small number of studies and patients enrolled, highlighting the need for more rigorous research in this area in developing countries.
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The authors of those systematic reviews noted insufficient evidence to support scale-up of mHealth interventions because there were only five studies from sub-Saharan African countries and only nine studies from developing countries.
“However, the authors also noted that there was insufficient evidence to support the scale-up of mHealth interventions because there were only five studies from SSA countries [6] and only nine studies from developing countries [9, 10].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [10]
Three recent systematic reviews found that included studies generally reported positive outcomes for mHealth interventions for NCDs or chronic diseases in sub-Saharan Africa and developing countries.
“Three recent systematic reviews, two specifically focusing on the use of mHealth interventions for the care and management of NCDs in SSA [6] and in developing countries [9], and the other looking more broadly at the use of mHealth interventions against chronic diseases in developing countries [10], found that the included studies generally reported positive outcomes.”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [10]
This review included a wider scope of evidence than previous reviews.
“Following a realist methodology, it has included a wider scope of evidence than previous reviews [6, 10], and it has focused on the policy-relevant questions of how, for whom, and in what circumstances mHealth interventions facilitate access to care.”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [10]
Eight reviews assessed the impact on asthma control through symptom scores, quality of life, or unscheduled health care.
“A total of 8 reviews assessed the impact on asthma control through symptom scores, quality of life, or unscheduled health care [20,24,27,28,36,61-63].”
Nine reviews analyzed telehealth interventions for heart failure.
“A total of 9 reviews analyzed telehealth interventions for heart failure [16,20,28,55-60].”
One 1-star review focused on mobile interventions in developing countries found evidence for improved symptom scores in a single RCT.
“Three 1-star reviews, all with narrative syntheses, concluded that further evaluation was needed before conclusions could be reached [28,36,61], while 1 other, focused on mobile interventions in developing countries, found evidence for improved symptom scores in a single RCT [20].”
Beratarrechea et al. evaluated text and automated voice interventions for chronic diseases in the developing world.
“Beratarrechea et al. [15] evaluated text and automated voice interventions for chronic diseases in the developing world”
From A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries (2016) · cites this paper as [15]
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- Authors
- Beratarrechea, A., Lee, A. G., Willner, J. M., Jahangir, E., Ciapponi, A., & Rubinstein, A.
- Affiliations
- Instituto de Efectividad Clínica y Sanitaria (AR)
- Fogarty International Center (US)
- Corresponding author
- Beratarrechea, Andrea
- Venue
- Telemedicine and e-Health
- Publisher
- SAGE Publications
- Published
- 2014-01
- Volume
- 20
- Issue
- 1
- Pages
- 75-82
- ISSN
- 1530-5627 (ISSN-L)
- 1556-3669
- PMC
- PMC3880111
- OpenAlex
- W2118764052
- Cited by
- 403
- References
- 42
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 29 · 2023: 24 · 2022: 43 · 2021: 53 · 2020: 33 · 2019: 50 · 2018: 38 · 2017: 31 · 2016: 36 · 2015: 25 · 2014: 7
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Telemedicine Journal and e-Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vanderbilt University (R24 TW007988)
- National Institutes of Health
- National Heart, Lung, and Blood Institute (T32HL007411)
- National Institute of Mental Health
- National Institute of Allergy and Infectious Diseases
- Fogarty International Center (R24TW007988)
- Office of Women's Health
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
- Keywords
- mobile health, chronic disease, low- and middle-income countries, text messaging intervention, health-related quality of life, health care costs, medication adherence, hospitalization rates, morbidity and mortality, process of care, health care access
- MeSH terms
- Chronic Disease, Developing Countries, Health Services Accessibility, Humans, Quality of Life, Risk Factors, Outcome Assessment, Health Care, Telemedicine, Disease Management, Cell Phone, Text Messaging
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