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Patient-reported Benefits and Limitations of Mobile Health Technologies for Diabetes in Pregnancy: A Scoping Review

Published:August 11, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.08.001

      Abstract

      Objectives

      For women with pre-existing and gestational diabetes, pregnancy involves specialized and intensive medical care to optimize maternal and infant outcomes. Medical management for patients with diabetes in pregnancy typically occurs via frequent face-to-face outpatient appointments. COVID-19–induced barriers to face-to-face care have identified the need for high-quality, patient-centred virtual health-care modalities, such as mobile health (mHealth) technologies. Our aim in this review was to identify the patient-reported benefits and limitations of mHealth technologies among women with diabetes in pregnancy. We also aimed to determine how the women’s experiences aligned with the best practice standards for patient-centred communication.

      Methods

      The framework presented by Arksey and O’Malley for conducting scoping reviews, with refinements by Levac et al, was used to guide this review. Relevant studies were identified through comprehensive database searches of MEDLINE, Embase, Emcare and PsycINFO. Thomas and Harden's methods for the thematic synthesis of qualitative research in systematic reviews guided the synthesis of patient-reported benefits and limitations of mHealth technology.

      Results

      Overall, 19 studies describing the use of 16 unique mobile health technologies among 742 women were included in the final review. Patient-reported benefits of mobile health included convenience, support of psychosocial well-being and facilitation of diabetes self-management. Patient-reported limitations included lack of important technological features, perceived burdensome aspects of mHealth and lack of trust in virtual health care.

      Conclusions

      Women with diabetes report some benefits from mHealth use during pregnancy. Codesigning future technologies with end-users may help address the perceived limitations and effectiveness of mHealth technologies.

      Résumé

      Objectifs

      Durant la grossesse des femmes qui ont un diabète préexistant et gestationnel, des soins spécialisés et intensifs sont nécessaires à l’optimisation des issues chez la mère et le nourrisson. La prise en charge médicale des patientes diabétiques durant la grossesse s’effectue généralement par des consultations externes fréquentes en personne. Les obstacles aux soins en personne occasionnés par la COVID-19 ont fait ressortir la nécessité de modalités en matière de soins virtuels de haute qualité axés sur le patient tels que les technologies mobiles de la santé (santé mobile). L’objectif de notre présente revue était de cerner les avantages et les limites en matière de technologies mobiles de la santé chez les femmes diabétiques durant la grossesse. Nous avions aussi comme objectif de déterminer comment les expériences des femmes s’harmonisent aux normes de pratiques exemplaires en matière de communication axée sur le patient.

      Méthodes

      Pour réaliser cette revue, nous avons suivi le cadre proposé par Arksey et O’Malley sur les études de la portée, et affiné par Levac et coll. Nous avons trouvé des études pertinentes grâce à des recherches exhaustives dans les bases de données de MEDLINE, Embase, EmCare et PsycINFO. Les méthodes de synthèse thématique en recherche qualitative selon Thomas et Harden dans les revues systématiques ont permis d’orienter la synthèse des avantages et des limites de la santé mobile signalés par les patientes.

      Résultats

      Au total, nous avons inclus à la revue finale 19 études qui décrivaient l’utilisation de 16 technologies mobiles uniques de la santé par 742 femmes. Les patientes ont signalé les avantages de la santé mobile suivants : la commodité, le soutien en matière de bien-être psychosocial et la facilitation de la prise en charge autonome. Les patientes ont aussi signalé les limites suivantes : le manque de caractéristiques technologiques importantes, les aspects contraignants perçus de la santé mobile et le manque de confiance dans les soins de santé virtuels.

      Conclusions

      Les femmes diabétiques signalent certains avantages de l’utilisation de la santé mobile durant la grossesse. La conception participative qui favorise la participation d’utilisatrices finales à la création des futures technologies peut permettre d’aborder les limites perçues et l’efficacité des technologies mobiles de la santé.

      Keywords

      Mots clés

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