The development of consumer mHealth interventions for chronic condition self-management: A systematic review.

Background:Innovative, patient-centred mHealth interventions have the potential to help with the burden of chronic conditions, yet development processes are seldom reported.Objective:To describe the development of consumer mHealth interventions for chronic condition self-management.Methods:CINAHL, Pubmed, PsychINFO and Embase databases were searched on 2nd September 2016 and re-searched on 22nd February 2017. Eligible reports were those published since 2010 that provided information on consumer mHealth interventions to assist the self-management of the priority non-communicable diseases determined by the World Health Organisation; respiratory disease, cancer, diabetes and cardiovascular disease.Results:Nineteen reports were included, representing the development of 13 mHealth interventions covering each of the four disease categories. Most were collaboratively developed, using user-centred and participatory design processes with patients/users, healthcare professionals and experts with the aim to support patient enablement and accessibility. Pre-design work involved a thorough needs assessment, often specific to the healthcare context. The re-design processes were described as iterative, engaging with usability testing and incorporating findings into design improvements. A demonstration of the importance of a user-centred philosophy and incorporating participatory design in mHealth development were key research findings. Tensions of competing priorities between patients and healthcare professionals throughout development were uncovered, with the intention to develop a useful product for the patient whilst ensuring clinical relevance.Conclusions:This review provides clear evidence that consumer mHealth interventions are developed inconsistently even when engaging with participatory or user-centred design principles, sometimes without direct involvement of patients themselves. The relative paucity of articles and the incomplete description of the development processes within the articles, presents challenges to furthering the knowledge base within the speciality. Healthcare professionals need timely access to quality information on mHealth products in order to recommend safe, effective consumer mHealth interventions to complement existing healthcare services. Robustly developed mHealth innovations may advance healthcare beyond the traditional methods of delivery to be accessible, reliable and useful to the many community-dwelling individuals living with a chronic condition