Effect of Multimodal App-Based Interventions on Glycemic Control in Patients With Type 2 Diabetes: Systematic Review...

Area of Science:

• Digital Health
• Diabetes Management
• Evidence-Based Medicine

Background:

• Digital technologies offer significant potential for long-term improvement in type 2 diabetes mellitus (T2DM) care.
• A subset of digital interventions meet criteria for prescribable digital health apps (DiGAs) in Germany.
• Digital treatments generate valuable patient data for evidence generation.

Purpose of the Study:

• To systematically review the efficacy of multimodal digital therapies, primarily meeting DiGA criteria, for T2DM patients.
• To assess the potential of these digital therapies using evidence from randomized controlled trials (RCTs) and real-world data.
• To determine the impact on glycated hemoglobin (HbA1c) levels, a key indicator of long-term blood glucose control.

Main Methods:

• Systematic literature search across PubMed, LIVIVO, and Cochrane using a PICO framework.
• Assessment of identified studies for risk of bias, pragmatism, and overall quality of evidence.
• Meta-analyses conducted on RCTs for between-group differences and on RCTs/non-RCTs for within-group differences in HbA1c.

Main Results:

• 24 studies were eligible for review, with 23 included in meta-analysis.
• Meta-analyses revealed significant and clinically relevant reductions in HbA1c for T2DM patients using app-based interventions.
• Pooled RCTs showed a between-group HbA1c reduction of -0.36%; average within-group reduction was -0.79%, with low to very low overall quality of evidence.

Conclusions:

• Digital therapies meeting DiGA criteria effectively improve HbA1c in T2DM patients.
• These digital health interventions demonstrate potential as a valuable complementary option within standard T2DM care.
• Integration of digital health into routine care is recommended for future consideration.