Mobile health interventions for improving colorectal cancer screening rates: A systematic review and meta-analysis.

Anton Elepaño,Jereel Aron Sahagun,Alyssa Samantha Fusingan,Eric Yasay

doi:10.31557/apjcp.2021.22.10.3093

Abstract

Objective:The aim of this systematic review and meta-analysis was to determine the efficacy of different mHealth interventions in increasing colorectal cancer (CRC) screening rates. Methods:A literature search for eligible studies was done in ClinicalTrials.gov, PubMed, and Scopus in October 2020. Included studies were randomized controlled trials done on adults due for CRC screening, who received either an mHealth intervention to promote screening or usual care. The primary outcome from these studies was completion of CRC screening. Two reviewers independently worked on selecting studies, collecting data, and determining risk of bias. Adjusted odds ratios (AOR) for CRC screening rates were summarized into a Forest plot. Results:A total of ten trials from three continents were included in the qualitative analysis. Risk of bias is low in terms of randomization, but high in terms of participant blinding, due to the nature of the interventions. Meta-analysis of four trials showed low clinical and statistical heterogeneity (I2=0%). Overall, the use of mHealth interventions is associated with higher CRC screening uptake when compared to usual care (AOR 1.33; 95% CI, 1.20-1.46). This effect was seen across different types of mHealth interventions, which included automated and non-automated telephone education and text-message reminders. Conclusion:This study showed that mHealth is associated with increased CRC screening participation regardless of the type of intervention used.

Highlights

Mobile health is loosely defined by the World Health Organization as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices” (Kay et al, 2011)
Trials were considered if the experimental group received an Mobile health (mHealth) intervention designed to promote Colorectal cancer (CRC) screening which may include electronic messages delivered through a mobile phone, telephone calls offering basic patient education, web-based counselling, or mobile apps with a decision support system
The primary study outcome of interest was the completion of a CRC screening method such as colonoscopy, flexible sigmoidoscopy, fecal immunochemical test (FIT), or fecal occult blood test (FOBT)

Summary

Introduction

Mobile health (mHealth) is loosely defined by the World Health Organization as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices” (Kay et al, 2011). Applications of mHealth include healthy lifestyle promotion, diagnosis and education, healthcare facility finder, and appointment reminders (Silva et al, 2015). Compared with face-to-face delivery of health services, mHealth offers advantages in terms of accessibility, cost, and the option to send out automated reminders (Silva et al, 2015; Moset et al, 2010). If detected in its earliest stage, more than 90% of patients with colorectal cancer survive beyond five years (Gomez et al, 2007). Screening programs come in the form of population-based programs, in which individuals at increased risk for colorectal cancer are actively identified and contacted; or in the form of opportunistic programs, which rely on the initiative of the healthcare provider to encourage patients to participate in screening (Gomez et al, 2007)

Methods

Results

Conclusion