INTRODUCTION: Mobile health apps aimed at patients are an emerging field of medicine. They offer an unprecedented possibility to improve healthcare accessibility, personalization, better lifestyle intervention and self-management for chronic conditions, and to make real-time feedback and support a reality.
OBJECTIVE: To conduct an overview of the current evidence on the effectiveness of apps, to identify the availability of health apps that were proven to be effective and ready to be prescribed, and to determine gaps in research.
METHODS: We searched four databases from 2008 onwards, hand searched Journal of Medical Internet Research, and conducted citation analysis of included articles. We included systematic reviews that covered relevant randomized controlled trials (RCTs), which evaluated effectiveness of health apps. We ascertained the availability and future release of apps by contacting the authors of the primary studies. Data were extracted on study population, intervention, comparator and objectively measured outcomes.
RESULTS: We included 6 systematic reviews, which evaluated a total of 23 relevant RCTs of 30 apps, of which 12 were already available, 7 were planned for release after trials, 8 were discontinued, and 3 were commercialized. Evidence of effectiveness was weak. Most studies were pilot trials, and only 4 studies showed meaningful effect attributable to apps. Health apps were most commonly created for reducing obesity, increasing physical activity, self-management of chronic diseases such as diabetes and mental health disorders. Risk of bias of included studies was high in study appraisal, and synthesis and findings domains.
CONCLUSIONS: Health app acceptance and feasibility are high. However, ninety nine percent of all available health apps in the app stores have never been tested for their effectiveness by randomized trials. Future research should aim to improve the design of effectiveness trials and to encourage health app testing to reduce research waste in this emerging area.
Conflict of interest: None declared.