Core characteristics, and effectiveness of mobile health interventions on dyspnoea and quality of life in older persons with chronic obstructive pulmonary disease: A systematic review and meta-analysis of randomised controlled trials.

AIM: To systematically review the core characteristics, and effectiveness of mobile health interventions (MHIs) on dyspnoea and quality of life (QoL) in older persons with chronic obstructive pulmonary disease (COPD).

METHODS

A comprehensive search was conducted from inception to 21 February 2023 in Chinese and English databases, with an updated search performed on 30 April 2024. Randomised controlled trials (RCTs) involving MHIs with four core functions - customisation, self-monitoring, alerts, and goal-setting - in older persons with COPD were included. Two reviewers independently identified the core characteristics of MHIs using the Template for Intervention Description and Replication (TIDieR) checklist. The Cochrane risk-of-bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were used to assess the methodological quality of RCTs and the overall quality of evidence.

RESULTS

28 RCTs were included, with 43% of studies adequately reported core characteristics of MHIs according to the TIDieR checklist. Meta-analysis suggested that MHIs may alleviate dyspnoea and improve disease-specific QoL questionnaires (CRQ and CCQ) and generic-related QoL questionnaires (SF-36 and EQ-5D), but not other disease-specific QoL questionnaires (SGRQ and CAT). Subgroup analyses showed that multi-component MHIs were effective in improving dyspnoea. Dyspnoea showed statistically significant improvement at 3 months, 6 months and 12 months, whereas QoL improved at 4 months (SGRQ), 2 months (CAT) and 6 months (CAT).

CONCLUSION

Reporting on the core characteristics of MHIs is currently incomplete, and it is recommended that healthcare professionals develop and report multi-component MHIs based on the TIDieR checklist to help alleviate dyspnoea and enhance QoL in older persons with COPD.