Systematic review: The use of mHealth in Healthy Ageing and Age-friendly Long Term Care and Services with a focus on the Western Pacific Region

Project Status
Current

Chief Investigator
Siaw-Teng Liaw

Research Team
Sameera Ansari, Jitendra Jonnagaddala, Mahfuz Ashraf, Padmanesan Narasimhan, Ben Harris-Roxas, Mark Harris

Background

Advanced health and medical technology and improved health care and public health have led to increased longevity and a growing population of people over 60. Ageing is a key public health challenge, especially in low and middle-income countries (LMICs) where limited resources, poor infrastructure and under-strength health systems are significant problems.

A whole-of-system approach is needed to promote healthy ageing and support the delivery of age-friendly health and long-term care. Digital health, particularly mobile health (mHealth) applications based on mobile and smart phones, and technology transfer to LMICs represent a unique opportunity to improve access and equity of health services to the elderly specifically and to the population generally. The use of mobile and smart phones is almost ubiquitous as they become more affordable and wireless connectivity become more widespread and more reliable. Despite the above, mHealth is still poorly used.

The Regional Meeting on Ageing and Health in the Western Pacific meeting report concluded with a request for WHO to “promote innovation on ageing and health, including e-Health and m-Health applications and technology transfer”.

Objectives

This review seeks to research the current situation and support this recommendation (and others) by reviewing:

  1. How mHealth is being used by stakeholders to promote healthy ageing and support the delivery of age-friendly health and long-term care services?
  2. What are the effective models for implementing mHealth?
  3. What are the lessons learnt from implementing mHealth initiatives?
  4. If there is enough evidence to support the impact of mHealth?

Methods

A comprehensive systematic review of peer-reviewed, scientific literature and a search of the Google Play Store for apps related to ageing and long-term care.

Findings relevant to the Western Pacific Region (WPR)

Only 13 out of 20 studies were conducted in HICs within the WPR, with only seven studies conducted in LMICs - China (4), Malaysia (1), Cambodia (1) and Philippines (1). No studies were conducted in the Pacific Islands. This is a reflection of the poor Internet access, information and communication technology (ICT) infrastructure or, and in case of Pacific Island countries, even unreliable power supply. The lack of studies on falls prevention, age-friendly environments or violence and injury among older people in the Western Pacific Region reflects the underlying sociocultural factors, political realities and governance structures, along with the technical and infrastructure factors.

Conclusions

Digital health and mHealth can play a significant role in supporting healthy ageing in the home and community, and in improving equitable access to age-friendly care when needed. They are yet to achieve their potential, but the positive findings from some pilot studies of mHealth apps in WPR countries, along with positive attitudes towards digital health expressed by participating communities and individuals, augur well for the future.

Final Report

https://cphce.unsw.edu.au/sites/default/files/publication_related_files/WHO_mHealth_review_final%20report%2Battachments_0.pdf