Assessing the Effectiveness of mHealth Interventions for Diabetes and Hypertension Management in Africa: Systematic Review and Meta-Analysis

BACKGROUND: Mobile health (mHealth) interventions are effective in improving chronic disease management, mainly in high-income countries. However, less is known about the efficacy of mHealth interventions for the reduction of cardiovascular risk factors, including for hypertension and diabetes, which are rapidly increasing in low- and middle-income countries. OBJECTIVE: This study aimed to assess the efficacy of mHealth interventions for diabetes and hypertension management in Africa. METHODS: We searched PubMed, Cochrane Library, Google Scholar, African Journals Online, and Web of Science for relevant studies published from inception to July 2022. The main outcomes of interest were changes in hemoglobin A(1c) (HbA(1c)), systolic blood pressure, and diastolic blood pressure. The random or fixed effect model was used for the meta-analysis, and the I (2) statistic was used to gauge study heterogeneity. Z tests and P values were used to evaluate the effect of mHealth interventions on HbA(1c) and blood pressure levels. RESULTS: This review included 7 studies (randomized controlled trials) with a total of 2249 participants. Two studies assessed the effect of mHealth on glycemic control, and 5 studies assessed the effect of mHealth on blood pressure control. The use of mHealth interventions was not associated with significant reductions in HbA(1c) levels (weighted mean difference [WMD] 0.20, 95% CI −0.40 to 0.80; P=.51) among patients with diabetes and systolic blood pressure (WMD −1.39, 95% CI −4.46 to 1.68; P=.37) and diastolic blood pressure (WMD 0.36, 95% CI −1.37 to 2.05; P=.69) among patients with hypertension. After conducting sensitivity analyses using the leave-one-out method, the Kingue et al study had an impact on the intervention, resulting in a 2 mm Hg reduction in systolic blood pressure (WMD −2.22, 95% CI −3.94 to −0.60; P=.01) but was nonsignificant for diastolic blood pressure and HbA(1c) levels after omitting the study. CONCLUSIONS: Our review provided no conclusive evidence for the effectiveness of mHealth interventions in reducing blood pressure and glycemic control in Africa among persons with diabetes and hypertension. To confirm these findings, larger randomized controlled trials are required. TRIAL REGISTRATION: PROSPERO CRD42021230642; https://‌www.crd.york.ac.uk/‌prospero/‌display_record.php?‌RecordID=‌230642