Background: Management of diabetes and chronic disease is a challenge, making mHealth an increasingly attractive option. There is evidence that these apps may be effective, with systematic reviews demonstrating improvements in HbA1c and other measures of diabetes control. However, dropout can be a major issue in apps. Recent research has indicated that rates of attrition in mHealth interventions may be as high as 98%. Knowledge of mHealth dropout rates is critical to assessing their efficacy.

Methods: Medline, Pubmed, Cochrane CENTRAL, and Embase were searched from 2003 to the present, looking at mHealth and attrition or dropout. Studies looking at chronic disease with measures of dropout were included.

Results: Of 830 studies identified in the literature search, 16 were included in the review and meta-analysis (results presented below). Chronic disease management apps had an overall dropout rate of 47%. Apps targeting metabolic disease had a lower rate of 32%. The studies were varied, with high heterogeneity (I2>99%).

Conclusion: Dropout rates in mHealth interventions are high, but lower in apps targeting metabolic disease. Reducing dropout rates will make these apps more effective for disease management in the long term.


G. Meyerowitz-Katz: None. T. Astell-Burt: None. S. Ravi: None. L.F. Arnolda: None. X. Feng: None.

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