Table 1.
Summary of included studies.
| Source | Country | Study design | Mobile health technology | Population | Outcome measures | Outcome category | Purpose |
| Blaya, 2009 [21] | Peru | RCTa | Mobile data collection | Health centers | Processing times, frequency of errors, the number of work-hours expended by data collectors | Technical outcome | For laboratory data collection |
| Mohammed, 2016 [22] | Pakistan | RCT | SMSb | TBc patients | Primary: clinically recorded treatment success based upon intention-to-treat; Secondary: treatment outcomes (WHO definitionsd), self-reported medication adherence, self-reported psychological and physical health measures | Treatment outcome, adherence, health outcome | For medication adherence |
| Bassett, 2013 [23]; Bassett, 2016 [24] | South Africa | RCT protocol (2013); RCT (2016) | SMS and phone calls | Patients at clinic | Primary: treatment completion; Secondary: mortality, receipt of CD4 count and TB test results, and repeat CD4 counts for those not antiretroviral therapy (ART)–eligible at baseline | Treatment outcome, mortality, process measure | For appointment and test result reminder and psychosocial support |
| Huang, 2017 [25] | China | Cluster RCT protocol | Mobile app | TB patients | Primary: TB treatment result (WHO definitionsd); Secondary: treatment adherence (the percentage of patients receiving TB treatment who missed fewer than 5% of doses), self-reported adherence, knowledge about TB, quality of life (QoL) | Treatment outcome, adherence, knowledge, QoL | For Bracelet- and self-directed observational therapy |
| Bediang, 2014 [26]; Bediang, 2018 [15] | Cameroon | RCT protocol (2014); RCT (2018) | SMS | TB patients | Primary: cure rate (absence of Koch’s bacilli in the sputum), treatment success (having completed 6 months' treatment and having negative sputum smears at 5 months); Secondary: treatment adherence (drug prescriptions collected and doses taken), attendance to appointments, punctuality of appointments, treatment outcome (WHO definitionsd), the number of participants who develop resistance, satisfaction | Treatment outcome, adherence, process measure, perception | For medication adherence |
| Khachadourian, 2015 [27] | Armenia | RCT protocol | SMS and phone calls | TB patients | Primary: physician-reported treatment outcome (WHO definitionsd); Secondary: patients’ knowledge, depression, QoL, within-family TB-related stigma, family social support, self-reported treatment adherence | Treatment outcome, knowledge, psychosocial outcome, QoL, adherence | For medication adherence |
| Chaiyachati, 2013 [28] | South Africa | Mixed-methods study | Mobile app | Health care workers | Primary: proportion of weekly adverse events forms submitted vs expected by mobile health care workers; Secondary: acceptability (perceived comfort levels with using mobile phone technology), quality of adverse events monitoring, proportion of reportable adverse events being captured; Technical outcomes: phone usage patterns, technical problems experienced | Process measure, perception, technical outcome | For adverse events reporting |
| Howard, 2016 [29] | Lesotho | Mixed-methods, cluster-randomized trial protocol | SMS | TB/HIV patients, health care workers | Primary: ART initiation, retention, and TB treatment success; Secondary: time to ART initiation, adherence, change in cluster of differentiation 4 (CD4) count, sputum smear conversion, cost-effectiveness, acceptability | Process measure, treatment outcome, adherence, cost-effectiveness, perception | For treatment adherence |
| Iribarren, 2013 [30] | Argentina | Mixed-methods study (including RCT) | SMS | TB patients | Primary: feasibility (access to mobile phones, familiarity with texting, rate of participant refusal, suboptimal TB understanding), and acceptability (feeling cared for patient’s treatment, self-reporting adherence); Secondary: initial efficacy (microscopy test result from positive to negative, treatment outcome) | Process measure, perception, adherence, treatment outcome | For treatment adherence |
| Hirsch-Moverman, 2017a [31] | Lesotho, Ethiopia | Mixed-methods; implementation science study | Phone calls | TB/HIV patients, TB patients |
The number of call attempts per participant for each month, completeness of monthly calls, success rates, challenges | Process measure | For medication adherence |
| Hirsch-Moverman, 2017b [32] | Lesotho | Mixed-methods implementation science study, cluster-randomized trial protocol | SMS | TB patients, health care workers, caregivers | Primary: the number of child contacts Isoniazid preventive therapy (IPT) initiation, IPT completion; Secondary: HIV testing, yield of active prevalent TB among child contacts, acceptability, and utilization of community-based intervention components | Treatment outcome, perception, process measure | For medication adherence and appointment reminders |
| Nguyen, 2017 [33] | Vietnam | Cohort study | SMS and mobile app | TB patients | Primary: proportion of patients completing all doses of self-administered treatment; Secondary: proportion of videos uploaded as scheduled, proportion of patients discontinuing using Video DOT (VDOT) | Treatment outcome, technical outcome, process measure | For medication adherence |
| Daftary, 2017 [34] | Ethiopia | Qualitative study | Interactive voice response (IVR) | HIV patients | Perceptions and attitude, perceived benefits and challenges | Perception | For preventive therapy adherence |
| Albino, 2014 [35] | Peru | Qualitative study | SMS | TB patients | Perceptions and acceptability | Perception | For treatment adherence |
| Nhavoto, 2017 [36] | Mozambique | Qualitative study | SMS | TB patients, Health care workers | Usefulness, perceived benefits, ease of use, satisfaction, risks of the SMS system | Perception | For treatment adherence |
| Hoffman, 2010 [37] | Kenya | Observational study | Mobile app | TB patients | Primary: technical feasibility (patient and health provider receptivity to remote directly observed treatment [DOT]); Secondary: patient preferences and receptivity to receiving TB health message on a mobile phone | Technical outcome, perception | For Mobile Direct Observation of Treatment |
| de Sumari-de Boer, 2016 [12] | Tanzania | Observational pilot study | SMS | HIV patients, TB patients | Quantitative: percentage of doses taken on time, percentage of sent reminders (divided by total intake prescription), percentage of correct reminders (after missed doses), percentage of incorrect reminders (after opening the pillbox but the signal was not sent), percentage of extra openings, percentage of missed doses, percentage of adherence with the exclusion of doses that were taken after a reminder; Qualitative: general experience with using the device | Process measure, adherence, perception | For medication adherence |
| Garfein, 2015 [38] | Mexico, USA | Observational pilot study | Mobile app | TB patients | Primary: adherence rate (the number of medication doses observed in videos divided by the number of doses expected during the treatment period); Secondary: perceptions of VDOT | Adherence, perception | For VDOT |
| Dwolatzky, 2006 [39] | South Africa | Observational pilot study | Mobile app | Patients at clinic | Time taken to locate the households | Technical outcome | For locating patients’ homes by global positioning system and personal digital assistant |
| Ha, 2016 [40] | Botswana | Implementation project | Mobile app | TB patients | Cases screened for contact tracing, time required to complete TB contact tracing per contact, quality of data collected, user satisfaction with usability, operational considerations | Technical outcome, perception | For contact tracing |
| Cowan, 2016 [41] | Mozambique | Implementation project | SMS and mobile app | Health facility | System installation on computers, development of Web-based interface and automated SMS and email messages, test results uploaded to the system, SMS notifications sent to key personnel, the number of users | Technical outcome | For remote monitoring solution |
| Kunawararak, 2011 [14] | Thailand | Implementation project | Phone calls | TB patients | Cure rates, completion rates, failure rates and success rates, conversion rates | Treatment outcome | For medication adherence |
| Lorent, 2014 [42] | Cambodia | Implementation project | SMS | General population | TB case detection- smear-positivity, clinical TB treatment uptake–time to treatment initiation outcome–treatment outcomes (WHO definitionsd), delay in linkage to care | Process measure, treatment outcome | For test result notification |
| Mahmud, 2010 [43] | Malawi | Implementation project | SMS | Health care workers | Operational net savings, worker time gained, patient enrollment | Process measure | For continuity of care |
| Narasimhan, 2014 [44] | India | Implementation project | SMS and phone calls | TB patients | Treatment completion and cure rates (WHO definitionsd), treatment adherence rates, adverse drug reaction rates, stigma associated with TB, patient satisfaction, usage of the mHealth initiative | Treatment outcome, adherence, perception | For medication adherence |
| Broomhead, 2012 [45] | South Africa | Cost minimization analysis | SMS | TB patients | Smear conversion rate, TB cure rate, reduced average cost per patient | Treatment outcome, cost | For treatment adherence |
| Hunchangsith, 2012 [46] | Thailand | Cost-effective-ness analysis | SMS | TB patients | Disability-adjusted life years (DALYs) averted, costs (health care perspective), effects of interventions, success rate, failure rate, transfer out rate, death rate | Health outcome, treatment outcome, cost, cost-effective-ness | For medication adherence |
aRCT: randomized controlled trial.
bSMS: short message service.
cTB: tuberculosis.
dWorld Health Organization definitions: presented in Multimedia Appendix 2.