The Effectiveness of Mobile Phone Messaging-Based Interventions to Promote Physical Activity in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis” (Preprint)

Background: Type 2 diabetes mellitus (T2DM) is increasing in prevalence worldwide. Physical activity (PA) is an important aspect of self-care and first-line management for T2DM. Mobile text messages (SMS) can be used to support self-management in people with T2DM, but the effectiveness of mobile text messages-based interventions in increasing physical activity is still unclear. Objective: The study aimed to assess the effectiveness of mobile phone messaging on PA in people with T2DM by summarizing and pooling the findings of previous literature. Methods: A systematic review was conducted to accomplish this objective. Search sources included 5 bibliographic databases (MEDLINE, Cochrane Library, CINAHL, Web of Science, EMBASE), the search engine “Google Scholar”, and backward and forward reference list checking of the included studies and relevant reviews. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence evaluation. Results of included studies were synthesized narratively and statistically, as appropriate. Results: We included 6 of 541 retrieved studies. Four of the studies showed a statistically significant effect of text messages on physical activity. Although a meta-analysis of results of two studies showed a statistically significant effect (P=.05) of text messages on physical activity, the effect was not clinically important. A meta-analysis of findings of 2 studies showed a non-significant effect (P=.14) of text messages on glycaemic control. Two studies found a non-significant effect of text messages on anthropometric measures (weight and BMI). Conclusions: Text messaging interventions show promise for increasing physical activity. However, it is not possible to conclude from this review whether text messages have a significant effect on physical activity, glycaemic control, or anthropometric measures among patients with T2DM. This is due to the limited number of studies, the high overall risk of bias in most of the included studies and the low quality of meta-analysed evidence. There is a need for more high-quality primary studies.