# Effectiveness of mHealth Interventions to Improve Follow-Up and Management Among Solid Organ Transplant Recipients: Systematic Review and Meta-Analysis

## TL;DR

This study reviews how mobile health tools help organ transplant patients manage their care and find that they improve self-care and reduce hospital readmissions.

## Contribution

The study provides a systematic review and meta-analysis of mHealth interventions for transplant recipients, revealing their impact on self-care and rehospitalization.

## Key findings

- mHealth interventions significantly improved self-care ability in transplant recipients.
- mHealth interventions reduced rehospitalization rates compared to usual care.
- No significant effect on mortality or complications was observed with mHealth interventions.

## Abstract

Effective follow-up and management after organ transplantation are crucial for transplant recipients. Mobile health (mHealth) interventions have emerged as a significant approach for facilitating follow-up and management. However, there is a lack of systematic reviews and meta-analyses of their effectiveness.

This study aimed to systematically review and synthesize evidence regarding the effectiveness of mHealth interventions in enhancing follow-up and management for transplant recipients.

This study included both randomized controlled trials (RCTs) and nonrandomized studies of interventions (NRSIs) that compared the effects of mHealth interventions with usual care in transplant recipients by searching PubMed, Web of Science, Scopus, Embase, CINAHL, and CENTRAL from database inception to June 2025. The primary outcomes included self-care ability, medical regimen adherence, self-monitoring, communication and counseling, medication adherence, physical activity, nutrition, all-cause mortality, complications, rehospitalization, and emergency and outpatient department visits. The risk of bias for each study was assessed using version 2 of the Cochrane risk-of-bias tool for RCTs and the Risk of Bias in Nonrandomized Studies of Interventions tool for NRSIs. Data extraction and quality assessment were conducted by 2 reviewers independently. Data synthesis was conducted using Review Manager. Both a meta-analysis and a narrative synthesis were carried out.

A total of 23 studies (n=15, 65% RCTs and n=8, 35% NRSIs) with 2022 transplant recipients were included. Compared to the control group, mHealth interventions significantly improved self-care ability (mean difference 14.49, 95% CI 9.61-19.36; P<.001) and reduced rehospitalization (odds ratio [OR] 0.49, 95% CI 0.34-0.71; P<.001). The meta-analysis demonstrated no statistically significant difference in mortality rates (OR 0.73, 95% CI 0.39-1.35; P=.31), rejection (OR 0.55, 95% CI 0.25-1.19; P=.13), or infection (OR 0.33, 95% CI 0.06-1.82; P=.20) between the mHealth intervention and control groups. The narrative synthesis indicated that mHealth interventions could effectively promote adherence to medical regimens and medications, facilitate self-monitoring, and improve communication and consultation.

mHealth interventions significantly improved self-care ability and reduced rehospitalization rates among organ transplant recipients. However, these interventions did not demonstrate a significant effect on all-cause mortality or complications. mHealth interventions showed potential benefits for various self-management behaviors in organ transplant recipients, but these findings need to be further verified. Future research should prioritize high-quality studies that investigate the impact of mHealth on physical activity, nutrition, and other patient-centered outcomes.

International Platform of Registered Systematic Review and Meta-Analysis Protocols INPLASY202480101; https://inplasy.com/inplasy-2024-8-0101/

RR2-10.37766/inplasy2024.8.0101