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Table 1 Summary of general study Characteristics

From: Clinical and patient-centered implementation outcomes of mHealth interventions for type 2 diabetes in low-and-middle income countries: a systematic review

Study and location

Study Design

Sample Size

Participant Age (Years)

Duration of Intervention

mHealth intervention delivery

Anzaldo et al. [44]

Mexico

RCT

n=301

I1: (Project Dulce)102; I2: (Project Dulce with Technology enhancement) 99

C: 100

18-75

10 months

Arm 1: PD TE: Interactive surveys, text messages, short educational videos

Arm 2: PD: combination of care management by a multidisciplinary team led by trained clinicians and nurses, as well as a peer-led group education

Bidirectional

Chai et al. [45]

China

Cohort

n=209

Mean age: 51.97

± 12.76

4 Months

Upload insulin dosages three or more times for the FPG and postprandial plasma glucose (PPG) on a panel computer

Chao et al. [46]

China

RCT

n=121;

I: 62; C: 59

C: Not provided

I: 63.71 (37 -88)

18 months

mobile app; Cloud-based IPMF

Bidirectional

Dong et al [47]

China

RCT

n=120

I: 60; C: 60

18-60 (23-60)

12 months

Web-based app: WeChat platform

Bidirectional

Doocy et al. [48]

Lebanon

Longitudinal Cohort

10 HC; 1020

< 40 a

20 months

mHealth app (PCHR),

Fottrell et al. [49]

India

CRCT

n=13,728

I1: 4,093; I2: 4,079

C: 5,008;

Mean Age not provided

Adults ≥30

18 months,

1. Voice messages

2-weekly (14 months

2. Monthly PLA group meetings (with a 4-phase PLA cycle)

Gunawardena et al. [50]

Sri Lanka

RCT

n=67

I: 35 C: 32

 I: 53 (SD 11), C: 52 (SD 12)

6 months

Android based Smart Glucose Manager (SGM) every 3 months

Goodarzi et al. [51]

Iran

RCT

n=100

I: 50, C: 50

I:50.98 (SD = 10.32)

C: 56.71 (SD = 9.77)

3 months

Text Messages:

4weekly messages

Unidirectional

Haddad et al. [52]

Iraq

Feasibility RCT

n=50

Mean: 51.4 (SD 10.3)

6 months

Text Messages

1 message per week 5

Bidirectional

Huo et al [53]

China

RCT

n=502

I: 251

C:251

Mean: 59.5 (SD 9.4)

I: 59.5 (SD 9.1)

C: 59.5 (SD 9.3)

6 months

Text Messages

6 SMSs per week for 6 months;

Weekly unidirectional messages

Bidirectional

Islam et al. [54]

Bangladesh

RCT

n=236

I:108; C:108

mean age: SD:

48.1 ± 6 9.7

6 Months

Text messages and Voice calls to the study team for any queries in response to the text message (with a 2-day response).

Bidirectional

Kumar et al. [55]

India

RCT

n=955

I: 479, C: 476

I: 57.5 (SD 10.8)

C: 57.0 (SD 10.7)

12 months

Text Messages

Patient specific frequency (average of 2 times per month for 12 months)

Unidirectional

Li et al. [56]

China

RCT

n=101

I: 55 C: 46

48.2 (SD 10.4)

3 months

R Plus Health app (Recovery Plus Inc), which connected wirelessly to a chest-worn heart rate band (Recovery Plus Inc) to

Liao et al [57].

China

CRCT

n=149

I:69, C: 80

13dancing groups

Mean age: 62

3 months

Wrist-worn activity trackers (Lifesense MAMBO2 wristbands)

Activity uploaded to the cloud via a paired smartphone device)

Physical activity reports on the paired smartphone via WeChat without support and peers

Limaye et al. [58]

India

RCT

n=265;

I: 132, C: 133

Mean: 36.2 (SD 9.3)

I: 36.8 (7.2)

C: 35.7 (8.1)

12 months

Text messages: 3 per wk

Emails: 2 e-mails/ wk between 1000–1300 h;

Website and Facebook

Bidirectional

10% of messages required reply

Olmen et al. [59]

Congo Cambodia Philippines

RCT

N=1471

Congo :506; Cambodia:484;

Philippines:481;

Overall: NP

I: 58 (SD 10)

C: 60 (SD 10)

24 months

Text Messages

Congo 5 times/wk; Cambodia: 6 times/wk Philippines: 2 times/week

Voice messages

Cambodia ¼ of all messages to specific groups,

Unidirectional

Owolabi et al. [60]

South Africa

RCT

n=216

I: 108, C: 108

Overall: 60.64 (SD 11.58)

6 Months

Standard of care plus

Tailored Short message services (SMS)

Unidirectional

Owolabi et al. [61]

South Africa

RCT

n=216

I: 108; C: 108

Overall: 60.64 (SD 11.58)

6 Months

Text Messages

Daily SMS: 2 times a week;

Unidirectional

Patnaik et al. [62]

India

RCT

n=66

I: 33 C: 33

42.29(SD 9.5)

24 Months

Mobile-based android application

Bi-directional

Peimani et al. [63]

Iran

RCT

n=150

I1: 50

I2: 50

I3: 50

I1:49.78(SD 9.76)

I2:53.26 (SD 10.49)

C: 54.56 (9.88)

3 months

Text Messages

Voice Calls

Arm 1: individually tailored SMS: each person received 75% of their messages tailored to 2 reported barriers to adherence

Arm 2: non- tailored SMS: random messages sent irrespective of barriers with Voice Calls: Weekly

Pichayapinyo et al. [64]

Thailand

Cohort

n=35

54.9 (SD:6.3)

4 Months

Interactive Voice Response (IVR) & email content was translated into Thai

IVR calls lasting 5–10 minutes each for 12 weeks

Pfammatter et al. [65]

India

Parallel Cohort

n= 1925

I: 982, C: 943

Overall: 32.2 (SD 10.6)

I: 32.83 (SD 9.39) C: 31.66 (SD 11.64)

6 months (Dec 2012-June 2013)

Text Messages

(Multilanguage texts)

Daily text messages for the first 6 days followed by 2 SMSs per week

Unidirectional

Rasoul et al. [66]

Iran

RCT

n=98

I: 49 C: 49

32.1 (SD 4.9)

5 months

Weblogs

Text, video, recorded voice, and nutrition pyramid for diabetic patients

3 days/week, 1:30 hr /session Total: 60 sessions

Rotheram-Borus et al. [67]

South Africa

 Cohort

n=22 (Women)

53 (SD 12.8)

3 months

followed by a post-trial FU at 6 months

Text Messaging

Diabetes Buddies program: 12 psycho-educational group sessions

Daily mobile phone probes on health

3 text messaging to a buddy: Frequency: Daily

Bidirectional

Shahid et al. [68]

Pakistan

RCT

n=440

I: 220 C: 220

 I: 48.93 SD(8.83), C 49.21 (SD 7.92)

6 months

Voice calls

Calls every 15 days for a period of 4 months: Total of 8 calls

Steinman et al [69]

Cambodia

CRCT

n=3948

C: 1,737, I: 1,099

NR

12 months

Tablet and mobile voice messages delivered via patient’s mobile phones

Sun et al. [70]

China

RCT

n=91

I: 44, C: 47

Overall: NP

I: 68.04 (66-72)b

C: 67.9 (66-71) b

6 months

Mobile Application

Bidirectional

Wang et al. [71]

China

RCT

n=120

I: 60, C:60

Mean age: 45.4

6 months

Mobile application

Yasmin et al. [72]

Bangladesh

RCT

n=320

I: 160

C: 160

I: 53 [30–85] C: 51 [30–75]

12 months

Personalized Voice calls every 10

days, except Fridays and other national holidays

Zhou et al. [73]

China

RCT

n=100

I: 50

C: 50

Overall: NP

I: 53.5 (SD 12.4)

C: 55.0 (SD 13.1)

3 months

Mobile Application

Welltang mobile App

App for both pts and clinician: 1. Transfers data to servers. Once per week/ Every 2 wks. Feedback: 3-10mins

  1. App Application; Personally controlled health record; PD Project Dulce–only; PD-TE Project Dulce technology enhanced with mobile tools; PPG postprandial plasma glucose; PT Patient; QA Question and answer; SBP systolic Blood Glucose; T2DM type 2 Diabetes Mellitus a Mean age not provided; b Interquartile rage