Health IT, Patient Engagement

Evidence remains thin for preventing heart disease via mobile health

Mobile and digital health technologies have become so popular that they are almost ubiquitous, but it is easy to forget that these are still relatively new fields in terms of clinical effectiveness, a new literature review shows.

Mobile and digital health technologies have become so popular that they are almost ubiquitous, but it is easy to forget that these are still relatively new fields in terms of clinical effectiveness. Given that the peer-review process can be arduous, it is not surprising that scientific evidence remains thin, albeit fairly broad.

In a newly published article in the journal Circulation, researchers affiliated with the American Heart Association reviewed 10 years of literature on the use of mobile health technologies for preventing cardiovascular diseases.

“Beyond consistent questions about product safety and effectiveness, our review of the field found almost no studies that analyzed how products worked or user input in its development,” the authors wrote in their long article. “Until such information is available, mobile app developers will continue to face questions and doubts from the public, providers and payers.”

Still, they were able to identify some trends among the 69 relevant studies they examined.

For example, in the area of obesity control, the research team found that “successful” mobile health interventions have a lot in common with offline programs. “The largest weight losses are produced by comprehensive, multicomponent interventions that are personally tailored, promote regular self-monitoring and involve a qualified interventionist,” they wrote.

Smoking cessation is another factor in prevention of heart disease. While there may only be about a decade’s worth of literature on mobile phone-based programs for quitting smoking, text messaging has proven to be effective.

“Within this short period, however, a number of large, well-controlled studies have shown that SMS programs produce approximately double the abstinence rates of minimal intervention control conditions,” the article said. However, about 90 percent of participants in these programs are still smoking after six months, so much work remains.

The American Heart Association committee members did offer some general recommendations for those considering apps and other mobile programs to prevent cardiovascular disease. An example:


Until more evidence emerges, health practitioners looking to implement or recommend mHealth interventions to their overweight and obese patients should ensure that the programs and tools they recommend include established evidence-based content and components of a comprehensive lifestyle intervention (i.e., calorie-controlled healthy eating and increased physical activity with specified goals and behavioral strategies) and facilitate adoption of evidence-based weight loss behaviors (e.g., self-monitoring, personalized feedback and social support from coaches or peers). In the context of these programs, mobile technologies, particularly SMS/multimedia messaging service messaging and smartphone apps, may be the primary intervention modality when supported by other methods (Web sites or telephone calls).