Review| Volume 8, ISSUE 4, P275-285, December 2014

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Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis

  • Mohsen Saffari
    Corresponding author at: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; and Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran. Tel.: +98 21 88040153; fax: +98 21 88608499.
    Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
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  • Ghader Ghanizadeh
    Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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  • Harold G. Koenig
    Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    King Abdulaziz University, Jeddah, Saudi Arabia
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      Diabetes type 2 is an increasing problem worldwide that may be managed through education. Text-messaging using a cell phone can assist with self-care. The aim of this study was to systematically review the impact of education through mobile text-messaging on glycemic control.


      The design was a systematic review with meta-analysis. Five electronic databases were searched to access English studies involving a randomized controlled trial design that used text-messaging educational interventions in patients with type 2 diabetes during an 11-year period (2003–2013). Studies were evaluated using a quality assessment scale adapted from Jadad scale and Cochrane handbook. Extraction of data was carried out by two reviewers. A random-effect model with a standardized mean difference and Hedges's g indices was used for conducting the meta-analysis. Subgroup analyses were conducted and a Funnel plot was used to examine publication bias.


      Ten studies overall were identified that fulfilled inclusion criteria, involving a total of 960 participants. The mean age of the sample was 52.8 years and majority were females. Data were heterogeneous (I2 = 67.6). Analyses suggested a publication bias based on Egger's regression (P < 0.05). HbA1c was reduced significantly in experimental groups compared to control groups (P < 0.001). The effect size for glycemic control in studies that used text-messaging only was 44%. For studies that used both text-messaging and Internet, the effect size was 86%.


      Mobile text-messaging for educating Type 2 diabetics appears to be effective on glycemic control. Further investigations on mobile applications to achieve educational goals involving other diseases are recommended.


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