Table 2.
Details of the 27 trials.
| Trial, publication year, study location | Trial length | Sample | HbA1c a/BPb eligibility | Intervention | Comparison treatment | |
| Type 2 diabetes |
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Anzaldo-Campos et al, 2016, Mexico | 10 months | IGc: n=102; CGd: n=100; mean age 52.0 years; male 38%; diabetes duration 8.3 years | HbA1c≥ 8% | A mobile app to facilitate self-monitoring of health-related data (eg, BGe and diet) and support from clinicians, nurses, and peer educators for care management | Usual care and the provision of educational classes and health evaluation in monthly medical group visits |
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Bender et al, 2017, US | 6 months | IG: n=22; CG: n=23; mean age 57.6 years; male 38%; diabetes duration not reported | No limit for HbA1c | A mobile app for behavior tracking, a Fitbit for steps monitoring, and social media for social support and education | Usual care and a Fitbit only for daily wear |
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Greenwood et al, 2015, US | 6 months | IG: n=45; CG: n=45; mean age 55.7 years; male 53%; diabetes duration 8.2 years | HbA1c: 7.5%-10.9% | A tablet-based app and a portal to support patients’ BG monitoring and diabetes education and enable certified diabetes educators’ access to patient data for telemonitoring | Usual care, booklets and referrals for diabetes education, and evaluation of patient self-reported glucose data by certified diabetes educators |
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Hansen et al, 2017, Denmark | 8 months | IG: n=83; CG: n=82; mean age 58 years; male 64%; diabetes duration 12.3 years | HbA1c> 7.5% | A tablet-based app to enable reporting of health-related data (eg, BG and BP) and monthly communication with HCPsf via video-conferencing | Usual care |
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Holmen et al (1), 2014, Norway | 12 months | IG: n=51; CG: n=25; mean age 57.7 years; male 64%; diabetes duration 10.6 years | HbA1c≥ 7.1% | A mobile phone-based system to enable vital sign monitoring, goal management, and motivational feedback | Usual care |
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Holmen et al (2), 2014, Norway | 12 months | IG: n=50; CG: n=25; mean age 56.9 years; male 53%; diabetes duration 9.5 years | HbA1c≥ 7.1% | A mobile phone-based system (to enable vital sign monitoring, goal management, and motivational feedback) and health counseling delivered by diabetes specialist nurses | Usual care |
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Hsu et al, 2016, US | 12 weeks | IG: n=20; CG: n=20; mean age 53.6 years; male sex not reported; diabetes duration 9.3 years | HbA1c: 9%-14% | A cloud-based diabetes management app supporting BG self-monitoring, insulin initiation/titration, shared decision making, and communication | Usual care with interim face-to-face visits and telephone/fax communication with educators, physicians, and/or nurses |
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Karhula et al, 2015, Finland | 12 months | IG: n=180; CG: n=70; mean age 66.3 years; male 56%; diabetes duration not reported | HbA1c> 6.5% | A mobile app for self-monitoring of health parameters (eg, BG and BP) and remote health coaching | Usual care |
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Kleinman et al, 2017, India | 6 months | IG: n=44; CG: n=46; mean age 48.4 years; male 70%; diabetes duration 9.2 years | HbA1c: 7.5%-12.5% | A smartphone app for patients and a web portal plus an app for HCPs for receiving reminders, data visualization, and providing care support to enhance self-care and collaborative care decisions | Usual care |
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Nagrebetsky et al, 2013, UK | 6 months | IG: n=7; CG: n=7; mean age 58 years; male 71%; diabetes duration 2.6 years | HbA1c: 8%-11% | A mobile phone-based telehealth platform (for self-monitoring of BG and self-titration of oral glucose-lowering medication) and monthly telephone calls (for lifestyle monitoring and change) | Usual care and monthly telephone calls for lifestyle monitoring and change |
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Orsama et al, 2013, Finland | 10 months | IG: n=24; CG: n=24; mean age 61.9 years; male 54%; diabetes duration not reported | HbA1c: 6.5%-11%; SBPg >140 mm Hg or DBPh >90 mm Hg | A diabetes lifestyle and self-care promotion program based on a mobile app to allow patients to report their conditions and receive system-generated feedback on health behaviors | Usual care, diabetes education, and HCP counseling |
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Quinn et al, 2008, US | 3 months | IG: n=13; CG: n=13; mean age 51.0 years; male 35%; diabetes duration 9.3 years | HbA1c ≥ 7.5% | A mobile phone-based software to provide real-time feedback on patient BG levels, display medication instructions, incorporate hypo- and hyperglycemia treatment algorithms, and request data for diabetes management | Usual care and instructions to patients about reporting BG levels to HCPs via phone calls or fax once every 2 weeks |
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Quinn et al, 2011, US (1) | 12 months | IG: n=23; CG: n=19; mean age 53 years; male 52%; diabetes duration 8.3 years | HbA1c ≥ 7.5% | A mobile app and patient care provider web portal to support patient self-monitoring and enable HCPs to receive health data shared by patients | Usual care |
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Quinn et al, 2011, US (2) | 12 months | IG: n=22; CG: n=19; mean age 53.5 years; male 46%; diabetes duration 7.8 years | HbA1c ≥ 7.5% | A mobile app and patient care provider web portal to support patient self-monitoring and allow HCPs to access unanalyzed patient data | Usual care |
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Quinn et al, 2011, US (3) | 12 months | IG: n=62; CG: n=18; mean age 52.3 years; male 50%; diabetes duration 8.5 years | HbA1c ≥ 7.5% | A mobile app and patient care provider web portal to support patient self-monitoring and allow HCPs to access analyzed patient data and evidence-based care guidelines | Usual care |
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Sun et al, 2019, China | 6 months | IG: n=44; CG: n=47; mean age 68.0 years; male 41%; diabetes duration 11.4 years | HbA1c: 7.0%-10.0% | A mobile app for self-monitoring of BG, diet, and physical activity; sharing of measurement records; and receiving HCP-provided care recommendations | Usual care |
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Takenga et al, 2014, Congo | 2 months | IG: n=20; CG: n=20; mean age 53.3 years; male 73%; diabetes duration not reported | No limit for HbA1c | A mobile system to support patients’ tracking of health conditions (eg, BG, BP, and body weight) and communication with HCPs | Usual care |
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Waki et al, 2014, Japan | 3 months | IG: n=27; CG: n=27; mean age 57.3 years; male 76%; diabetes duration 9.1 years | No limit for HbA1c | A smartphone-based system for self-monitoring of health conditions (eg, BG, BP, and diet), communication with HCPs, and receiving system’s auto-generated feedback | Usual care |
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Wayne et al, 2015, Canada | 6 months | IG: n=67; CG: n=64; mean age 53.2 years; male 28%; diabetes duration not reported | HbA1c ≥ 7.3% | A mobile phone-supported health coach program allowing patients to track their conditions (eg, BG, diet, physical activity, and mood) and communicate with HCPs | Usual care, exercise education, and health coach support in goal setting and progress monitoring through in-person meetings/telephones |
| Hypertension |
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Kim et al, 2016, US | 6 months | IG: n=52; CG: n=43; mean age 57.6 years; male 32%; hypertension duration not reported | No limit for BP | A mobile app (equipped with a BP monitoring device, electronic reminders, and a web-based disease management program for patient self-monitoring) and a reach-out program (delivered by nursing staff for education about medication, disease prevent, and chronic disease management) | Usual care and a reach-out program of the same type used in the IG |
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Lakshminarayan et al, 2018, US | 90 days | IG: n=34; CG: n=22; mean age 65.0 years; male 68%; hypertension duration not reported | No limit for BP | A smartphone app supporting BP self-monitoring, nurse-delivered education, and HCP-provided feedback | Usual care and education on hypertension management |
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Logan et al, 2012, Canada | 12 months | IG: n=55; CG: n=55; mean age 62.9 years; male 56%; hypertension duration not reported | SBP ≥130 mm Hg | A smartphone app (for BP telemonitoring and self-care) and a booklet (with information about self-management, treatments, and therapy goals) | Usual care and a booklet of the same type used in the IG |
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Márquez Contreras et al, 2019, Spain | 12 months | IG: n=73; CG: n=75; mean age 57.5 years; male sex 48%; hypertension duration not reported | No limit for BP | A smartphone app to promote education about hypertension and provide patients with reminders of appointments and medication | Usual care |
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Moore et al, 2014, US | 12 weeks | IG: n=20; CG: n=22; mean age 50.0 years; male 60%; hypertension duration not reported | BP: 140/90-180/120 mm Hg | A tablet-based app, virtual visits, instant messaging, and a nurse health coach to facilitate self-monitoring of BP and medication intake; visualization of information on actions, outcomes, and medication adjustment; and discussion about care management and goal settings | Usual care together with office visits, phone calls, and emails with HCPs for discussing care management, goal settings, and medication adjustment |
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Sarfo et al, 2019, Ghana | 9 months | IG: n=30; CG: n=30; mean age 55 years; male 65%; hypertension duration not reported | SBP ≥140 mm Hg | A smartphone app for monitoring and reporting of BP and medication intake, provision of motivational text messages generated based on patients’ medication adherence, and sharing of patients’ health reports with clinicians | Usual care and text messages about healthy lifestyle management and clinicians’ monthly review of patients’ BP |
| Type 2 diabetes and/or hypertension |
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Or and Tao, 2016, Hong Kong SAR, China | 3 months | IG: n=33; CG: n=30; mean age 69.5 years; male 32%; diabetes duration 12.5 years; hypertension duration 10.2 years | No limit for HbA1c and BP | A tablet-based self-monitoring app allowing automated recording and monitoring of BG and BP values and providing educational materials and decision aids | Usual care |
| Type 2 diabetes and hypertension |
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Yoo et al, 2009, Korea | 3 months | IG: n=57; CG: n=54; mean age 58.2 years; male 59%; diabetes duration 6.6 years; hypertension duration 3.7 years | HbA1c: 6.5%-10%; BP >130/80 mm Hg | An internet-enabled, cellphone-based system coupled with a BG measuring device, an automatic BP monitor, a body weight scale, and a database providing reminders, health recommendations, and data sharing for self-care | Usual care |
aHbA1c: hemoglobin A1c.
bBP: blood pressure.
cIG: intervention group.
dCG: control group.
eBG: blood glucose.
fHCP: health care provider.
gSBP: systolic blood pressure.
hDBP: diastolic blood pressure.