A systematic review on incentive-driven mHealth technology: As used in diabetes management

Abstract

Introduction Mobile Health (mHealth) technologies have been shown to improve self-management of chronic diseases, such as diabetes. However, mHealth tools, such as Apps, often have low rates of retention, eroding their potential benefits. Using incentives is a common mechanism for engaging and retaining patients that is applied by mHealth tools. We conducted a systematic review aiming to categorise the different types of incentive mechanisms employed in mHealth tools for diabetes management, which we defined as Incentive-driven Technologies (IDTs). As an auxiliary aim, we also analysed barriers to adoption of IDT technologies.

Methods Literature published in English between January 2008 and August 2014 was identified through searching leading publishers and indexing databases: IEEE, Springer, Science Direct, NCBI, ACM, Wiley and Google Scholar.

Results A total of 42 articles were selected. Of these, 34 presented mHealth tools with IDT mechanisms. Many of these contained more than one IDT, with Education the most common (n=21), followed by Reminder (n=11), Feedback (n=10), Social (n=8), Alert (n=5), Gamification (n=3), and Financial (n=2). The remaining 8 articles were review papers and a qualitative study of focus groups and interviews with patients with diabetes, where no new technologies were proposed, from which we defined barriers for adoption.

Discussion We identified that while mHealth technologies have advanced over the last 5 years, the core IDT mechanisms have remained consistent. Instead, IDT mechanisms have evolved with the upgrades in technology, such as moving from manual to automatic content delivery and personalisation of content.