Clinical efficacy and cost-effectiveness analysis of mobile health interventions in diabetes care: a systematic review and meta-analysis.

Diabetes mellitus is a chronic illness that is due to persistent high blood glucose levels that, when uncontrolled, can lead to major complications. Diabetes is rising in prevalence and currently affects millions of individuals worldwide. Mobile Health (mHealth) apps on electronic devices serve as a platform for technology-supported healthcare and can be an effective approach for optimal and effective diabetes management. This systematic review and meta-analysis aimed to evaluate the clinical and cost-effectiveness of mobile health (mHealth) interventions in diabetes care. This review includes both quantitative assessments of clinical effectiveness and economic evaluations to provide a comprehensive assessment of health interventions in diabetes management. A systematic literature search was conducted using PubMed, ScienceDirect, and Google Scholar to identify studies evaluating the clinical and economic effectiveness of mobile health (mHealth) interventions in diabetes management. Eligible studies included randomised controlled trials and economic evaluations involving mobile apps, SMS, or telehealth technologies. Data were extracted and cross-checked for accuracy. Quantitative synthesis of clinical outcomes, including HbA1c and quality of life, was conducted using Review Manager software. The quality of economic evaluations was assessed using the CHEERS 2022 checklist. Ten studies were included, with five reporting cost-effectiveness and nine reporting clinical outcomes. mHealth interventions significantly reduced HbA1c overall (pooled mean difference: − 0.31%, 95% CI: − 0.52 to − 0.10; p = 0.004). At 3 months, the effect was stronger and statistically significant (–0.61%, 95% CI: − 0.95 to − 0.26; p = 0.0006), but by 6 months, it declined to − 0.31% (95% CI: − 0.66 to 0.04) and was not significant (p = 0.09), reflecting reduced effect size rather than data limitations. BMI and blood pressure changes were minimal, while annual cost savings ranged from $449 to $881 per patient, primarily due to fewer hospitalizations and outpatient visits. Economic evaluations confirmed high cost-effectiveness (DALY costs as low as $124 per DALY averted), though QALY gains were marginal. Overall, our findings indicate the potential of mHealth interventions as useful tools in diabetes management, with significant short-term clinical benefits alongside substantial cost-savings. However, maintaining long-term clinical effectiveness remains a challenge. These results have important implications for healthcare providers, policy makers and stakeholders in further maximizing the potential of mHealth interventions as a critical component of diabetes care.