Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Tip 2 Diyabet Öz Yönetiminin Güçlendirilmesinde Mobil Sağlık Uygulamalarının Kullanımı: Literatür Derlemesi
Use of Mobile Health Applications in Strengthening Type 2 Diabetes Self Management: Literature Review
Merve YÜKSELa, Hicran BEKTAŞa
aAkdeniz Üniversitesi Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği ABD, Antalya, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2021;13(2):424-34
doi: 10.5336/nurses.2020-77016
Article Language: TR
Full Text
ÖZET
Tip 2 diyabetli bireylerde, glisemik kontrolün ve etkin yaşam tarzı değişikliğinin sağlanması ve öz yönetimin güçlendirilmesi için mobil sağlık uygulamalarının kullanılması önemlidir. Bu literatür derlemesinin amacı, Tip 2 diyabet öz yönetiminin güçlendirilmesinde kullanılan mobil sağlık uygulamalarının etkinliğinin belirlenmesidir. Mart ve Mayıs 2020 tarihleri arasında; PubMed, CINAHL, Web of Science, Cochrane Library, Scopus, ULAKBİM Ulusal Veri Tabanı ve Medline veri tabanlarında 'mobil sağlık, mobil uygulamalar, Tip 2 diyabet, diyabet öz yönetimi, hemşirelik' anahtar kelimeleriyle tarama yapılmıştır. Tarama sonucunda, 525 makaleye ulaşılmıştır. Örneklemini, 18 yaş üzeri ve Tip 2 diyabetli bireylerin oluşturduğu, mobil sağlık uygulamalarının etkinliğinin değerlendirildiği, Türkçe veya İngilizce dilinde çalışmalar incelenmiştir. Tam metnine ulaşılabilen ve İngilizce dilindeki sistematik derleme, metaanaliz ve randomize kontrollü toplam 34 çalışma literatür derlemesine dâhil edilmiştir. Son yıllarda Tip 2 diyabetli bireylerin tedavi ve bakım yönetimi için mobil sağlık uygulamaları giderek daha fazla kullanılmaktadır. Yapılan çalışmalarda, mobil sağlık uygulamalarının, Tip 2 diyabetli bireylerde diyete uyum, düzenli kan şekeri takibi, düzenli fiziksel aktivite, ilaç gereksiniminde ve HbA1c düzeylerinde azalma gibi öz yönetimin güçlendirilmesine katkı sağladığı vurgulanmaktadır. Mobil sağlık uygulamalarıyla yüz yüze danışmanlık süresinin ve sağlık maliyetlerinin azaldığı belirtilmektedir. Tip 2 diyabetli bireylerin öz yönetiminin güçlendirilebilmesi ve diyabet ilişkili komplikasyonların azaltılabilmesi için kanıt temelli mobil sağlık uygulamalarının kullanımı konusunda bireylerin hemşireler tarafından bilgilendirilmesi, düzenli ve sürekli eğitim ile desteklemesi önemlidir. Son dönemde, dünyada ve ülkemizde görülen pandemi nedeniyle, mobil sağlık uygulamalarının günlük hayatımızdaki ve kronik hastalık yönetimindeki önemi daha da belirginleşmiştir.

Anahtar Kelimeler: Diyabet öz yönetimi; hemşirelik; mobil uygulamalar; mobil sağlık; Tip 2 diyabet
ABSTRACT
It is important to use mobile health apps to ensure glycemic control and effective lifestyle change and strengthen selfmanagement in individuals with type 2 diabetes. The purpose of this literature review is to determine the effectiveness of mobile healthcare applications used to strengthen type 2 diabetes self-management. Between March and May 2020, a search was conducted in PubMed, CINAHL, Web of Science, Cochrane Library, Scopus, ULAKBIM National Database and Medline databases with the keywords "mobile health, mobile applications, type 2 diabetes, diabetes self-management, nursing". Studies in Turkish or English, which included individuals over the age of 18 and with type 2 diabetes, and evaluating the effectiveness of mobile health applications, were examined. A total of 34 English language systematic reviews, meta-analysis, and randomized controlled studies, whose full text is available, have been included in the literature review. In recent years, mobile health applications are increasingly used for the treatment and care management of individuals with type 2 diabetes. In studies conducted, it is emphasized that mobile health practices contribute to strengthening self-management, such as diet compliance, regular blood sugar monitoring, regular physical activity, decrease in drug requirement, and HbA1c levels in individuals with type 2 diabetes. It is stated that face to face counseling time and health costs are reduced with mobile health applications. To strengthen the self-management of individuals with type 2 diabetes and reduce diabetes-related complications, it is important that nurses are informed about the use of evidence-based mobile health applications and that they support them with regular and continuous education. Due to the pandemic in the world and our country recently, the importance of mobile health applications in our daily life and chronic disease management has become more evident.

Keywords: Diabetes self-management; nursing; mobile applications; mobile health; type 2 diabetes
REFERENCES:
  1. American Diabetes Association. Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(1):S14-31. [Crossref] [PubMed] 
  2. Cui M, Wu X, Mao J, Wang X, Nie M. T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(11):e0166718. [Crossref] [PubMed] [PMC] 
  3. Blondon K, Klasnja P, Coleman K, Pratt W. An exploration of attitudes toward the use of patient incentives to support diabetes self-management. Psychol Health. 2014;29(5):552-63. [Crossref] [PubMed] 
  4. Wu IXY, Kee JCY, Threapleton DE, Ma RCW, Lam VCK, Lee EKP, Wong SYS, Chung VCH. Effectiveness of smartphone technologies on glycaemic control in patients with type 2 diabetes: systematic review with meta-analysis of 17 trials. Obes Rev. 2018;19(6):825-38. [Crossref] [PubMed] 
  5. Moncrieft AE, Llabre MM, McCalla JR, Gutt M, Mendez AJ, Gellman MD, et al. Effects of a multicomponent life-style intervention on weight, glycemic control, depressive symptoms, and renal function in low-income, minority patients with type 2 diabetes: results of the community approach to lifestyle modification for diabetes randomized controlled trial. Psychosom Med. 2016;78(7):851-60. [Crossref] [PubMed] [PMC] 
  6. Whitehead LC, Crowe MT, Carter JD, Maskill VR, Carlyle D, Bugge C, Frampton CM. A nurse-led interdisciplinary approach to promote self-management of type 2 diabetes: a process evaluation of post-intervention experiences. J Eval Clin Pract. 2017;23(2):264-71. [Crossref] [PubMed] 
  7. Wu Y, Yao X, Vespasiani G, Nicolucci A, Dong Y, Kwong J, et al. Mobile app-based interventions to support diabetes self-management: a systematic review of randomized controlled trials to identify functions associated with glycemic efficacy. JMIR Mhealth Uhealth. 2017;5(3):e35. Erratum in: JMIR Mhealth Uhealth. 2018;6(1):e20. [Crossref] [PubMed] [PMC] 
  8. Wang Y, Li M, Zhao X, Pan X, Lu M, Lu J, et al. Effects of continuous care for patients with type 2 diabetes using mobile health application: A randomised controlled trial. Int J Health Plann Manage. 2019;34(3):1025-35. [Crossref] [PubMed] 
  9. Klösch M, Klösch C, Kundt FS, van der Zee-Neuen A, Dieplinger AM. eHealth systems for the optimised care of patients with type 2 diabetes. Br J Nurs. 2020;29(5):274-8. [Crossref] [PubMed] 
  10. Agarwal P, Mukerji G, Desveaux L, Ivers NM, Bhattacharyya O, Hensel JM, et al. Mobile app for improved self-management of type 2 diabetes: multicenter pragmatic randomized controlled trial. JMIR Mhealth Uhealth. 2019;7(1):e10321. [Crossref] [PubMed] [PMC] 
  11. World Health Organization. mHealth: New Horizons for Health Through Mobile Tech­nologies: Second Global Survey on eHealth. Global Observatory for eHealth series. 2011;(3):5-7. [Link] 
  12. Aitken M, Lyle J. Patient adoption of mHealth: Use, Evidence and Remaining Barriers to Mainstream Acceptance. Parsippany, New York: IMS Institute for Healthcare Informatics; 2015. p. 3-22. [Link] 
  13. Brzan PP, Rotman E, Pajnkihar M, Klanjsek P. Mobile Applications for Control and Self Management of Diabetes: A Systematic Review. J Med Syst. 2016;40(9):210. [Crossref] [PubMed] 
  14. Bhuyan SS, Lu N, Chandak A, Kim H, Wyant D, Bhatt J, et al. Use of mobile health applications for health-seeking behavior among US adults. J Med Syst. 2016;40(6):153. [Crossref] [PubMed] 
  15. Huang Z, Lum E, Car J. Medication management apps for diabetes: systematic assessment of the transparency and reliability of health ınformation dissemination. JMIR Mhealth Uhealth. 2020;8(2):e15364. [Crossref] [PubMed] [PMC] 
  16. Pal K, Eastwood SV, Michie S, Farmer A, Barnard ML, Peacock R, et al. Computer-based interventions to improve self-management in adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2014;37(6):1759-66. [Crossref] [PubMed] 
  17. Boels AM, Rutten G, Zuithoff N, de Wit A, Vos R. Effectiveness of diabetes self-management education via a smartphone application in insulin treated type 2 diabetes patients - design of a randomised controlled trial ('TRIGGER study'). BMC Endocr Disord. 2018;18(1):74. [Crossref] [PubMed] [PMC] 
  18. Holmen H, Torbjørnsen A, Wahl AK, Jenum AK, Småstuen MC, Arsand E, et al. A Mobile health intervention for self-management and lifestyle change for persons with type 2 diabetes, part 2: one-year results from the norwegian randomized controlled trial renewing health. JMIR Mhealth Uhealth. 2014;2(4):e57. [Crossref] [PubMed] [PMC] 
  19. Whitehead L, Seaton P. The effectiveness of self-management mobile phone and tablet apps in long-term condition management: a systematic review. J Med Internet Res. 2016;18(5):e97. [Crossref] [PubMed] [PMC] 
  20. Munster-Segev M, Fuerst O, Kaplan SA, Cahn A. Incorporation of a stress reducing mobile app in the care of patients with type 2 diabetes: a prospective study. JMIR Mhealth Uhealth. 2017;5(5):e75. [Crossref] [PubMed] [PMC] 
  21. Kumar S, Moseson H, Uppal J, Juusola JL. A diabetes mobile app with in-app coaching from a certified diabetes educator reduces a1c for individuals with type 2 diabetes. Diabetes Educ. 2018;44(3):226-36. [Crossref] [PubMed] 
  22. Jeffrey B, Bagala M, Creighton A, Leavey T, Nicholls S, Wood C, et al. Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users. Diabetol Metab Syndr. 2019;11:84. [Crossref] [PubMed] [PMC] 
  23. Koot D, Goh PSC, Lim RSM, Tian Y, Yau TY, Tan NC, et al. A mobile lifestyle management program (glycoleap) for people with type 2 diabetes: single-arm feasibility study. JMIR Mhealth Uhealth. 2019;7(5):e12965. [Crossref] [PubMed] [PMC] 
  24. Liang X, Wang Q, Yang X, Cao J, Chen J, Mo X, et al. Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med. 2011;28(4):455-63. [Crossref] [PubMed] 
  25. Desveaux L, Agarwal P, Shaw J, Hensel JM, Mukerji G, Onabajo N, et al. A randomized wait-list control trial to evaluate the impact of a mobile application to improve self-management of individuals with type 2 diabetes: a study protocol. BMC Med Inform Decis Mak. 2016;16(1):144. [Crossref] [PubMed] [PMC] 
  26. Hou C, Carter B, Hewitt J, Francisa T, Mayor S. Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials. Diabetes Care. 2016;39(11):2089-95. [Crossref] [PubMed] 
  27. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34(9):1934-42. Erratum in: Diabetes Care. 2013;36(11):3850. [Crossref] [PubMed] [PMC] 
  28. Waki K, Fujita H, Uchimura Y, Omae K, Aramaki E, Kato S, et al. DialBetics: A novel smartphone-based self-management support system for type 2 diabetes patients. J Diabetes Sci Technol. 2014;8(2):209-15. [Crossref] [PubMed] [PMC] 
  29. Zhou W, Chen M, Yuan J, Sun Y. Welltang - A smart phone-based diabetes management application-Improves blood glucose control in Chinese people with diabetes. Diabetes Res Clin Pract. 2016;116:105-10. [Crossref] [PubMed] 
  30. Humble JR, Tolley EA, Krukowski RA, Womack CR, Motley TS, Bailey JE. Use of and interest in mobile health for diabetes self-care in vulnerable populations. J Telemed Telecare. 2016;22(1):32-8. [Crossref] [PubMed] 
  31. Pludwinski S, Ahmad F, Wayne N, Ritvo P. Participant experiences in a smartphone-based health coaching intervention for type 2 diabetes: A qualitative inquiry. J Telemed Telecare. 2016;22(3):172-8. [Crossref] [PubMed] 
  32. Lie SS, Karlsen B, Oord ER, Graue M, Oftedal B. Dropout from an ehealth intervention for adults with type 2 diabetes: a qualitative study. J Med Internet Res. 2017;19(5):e187. [Crossref] [PubMed] [PMC] 
  33. Veazie S, Winchell K, Gilbert J, Paynter R, Ivlev I, Eden KB, et al. Rapid Evidence Review of Mobile Applications for Self-management of Diabetes. J Gen Intern Med. 2018;33(7):1167-76. [Crossref] [PubMed] [PMC] 
  34. van der Weegen S, Verwey R, Spreeuwenberg M, Tange H, van der Weijden T, et al. It's life! mobile and web-based monitoring and feedback tool embedded in primary care increases physical activity: A Cluster Randomized Controlled Trial. J Med Internet Res. 2015;17(7):e184. [Crossref] [PubMed] [PMC] 
  35. Georgsson M, Staggers N. Patients' perceptions and experiences of a mhealth diabetes self-management system. Comput Inform Nurs. 2017;35(3):122-30. [Crossref] [PubMed] 
  36. El-Gayar O, Timsina P, Nawar N, Eid W. Mobile applications for diabetes self-management: status and potential. J Diabetes Sci Technol. 2013;7(1):247-62. [Crossref] [PubMed] [PMC] 
  37. Vervloet M, Linn AJ, van Weert JC, de Bakker DH, Bouvy ML, van Dijk L. The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. 2012;19(5):696-704. [Crossref] [PubMed] [PMC] 
  38. Dayer L, Heldenbrand S, Anderson P, Gubbins PO, Martin BC. Smartphone medication adherence apps: potential benefits to patients and providers. J Am Pharm Assoc (2003). 2013;53(2):172-81. [Crossref] [PubMed] [PMC] 
  39. Huang Z, Lum E, Jimenez G, Semwal M, Sloot P, Car J. Medication management support in diabetes: a systematic assessment of diabetes self-management apps. BMC Med. 2019;17(1):127. [Crossref] [PubMed] [PMC] 
  40. Martinez M, Park SB, Maison I, Mody V, Soh LS, Parihar HS. iOS appstore-based phone apps for diabetes management: potential for use in medication adherence. JMIR Diabetes. 2017;2(2):e12. [Crossref] [PubMed] [PMC] 
  41. Kebede MM, Pischke CR. Popular diabetes apps and the impact of diabetes app use on self-care behaviour: a survey among the digital community of persons with diabetes on social media. Front Endocrinol (Lausanne). 2019;10:135. Erratum in: Front Endocrinol (Lausanne). 2019;10:220. [Crossref] [PubMed] [PMC] 
  42. Adu MD, Malabu UH, Malau-Aduli AEO, Drovandi A, Malau-Aduli BS. Efficacy and acceptability of my care hub mobile app to support self-management in Australians with Type 1 or Type 2 Diabetes. Int J Environ Res Public Health. 2020;17(7):2573. [Crossref] [PubMed] [PMC] 
  43. Pustozerov E, Popova P, Tkachuk A, Bolotko Y, Yuldashev Z, Grineva E. Development and evaluation of a mobile personalized blood glucose prediction system for patients with gestational diabetes mellitus. JMIR Mhealth Uhealth. 2018;6(1):e6. [Crossref] [PubMed] [PMC] 
  44. Hoppe CD, Cade JE, Carter M. An evaluation of diabetes targeted apps for Android smartphone in relation to behaviour change techniques. J Hum Nutr Diet. 2017;30(3):326-38. [Crossref] [PubMed] 
  45. Torbjørnsen A, Småstuen MC, Jenum AK, Årsand E, Ribu L. Acceptability of an mhealth app intervention for persons with type 2 diabetes and its associations with initial self-management: randomized controlled trial. JMIR Mhealth Uhealth. 2018;6(5):e125. [Crossref] [PubMed] [PMC] 
  46. Trawley S, Baptista S, Browne JL, Pouwer F, Speight J. The use of mobile applications among adults with type 1 and type 2 diabetes: results from the second miles-Australia (MILES-2) Study. Diabetes Technol Ther. 2017;19(12):730-8. [Crossref] [PubMed] 
  47. Kho SES, Lim SG, Hoi WH, Ng PL, Tan L, Kowitlawakul Y. The development of a diabetes application for patients with poorly controlled type 2 diabetes mellitus. Comput Inform Nurs. 2019;37(2):99-106. [Crossref] [PubMed] 
  48. Png ME, Yoong J, Phan TP, Wee HL. Current and future economic burden of diabetes among working-age adults in Asia: conservative estimates for Singapore from 2010-2050. BMC Public Health. 2016;16:153. Erratum in: BMC Public Health. 2016;16(1):589. [Crossref] [PubMed] [PMC] 
  49. Goyal S, Cafazzo JA. Mobile phone health apps for diabetes management: current evidence and future developments. QJM. 2013;106(12):1067-9. [Crossref] [PubMed] [PMC] 
  50. Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Users' preferences and design recommendations to promote engagements with mobile apps for diabetes self-management: Multi-national perspectives. PLoS One. 2018;13(12):e0208942. [Crossref] [PubMed] [PMC] 
  51. Alvarado MM, Kum HC, Gonzalez Coronado K, Foster MJ, Ortega P, Lawley MA. Barriers to remote health interventions for type 2 diabetes: a systematic review and proposed classification scheme. J Med Internet Res. 2017;19(2):e28. [Crossref] [PubMed] [PMC] 
  52. Scott AR, Alore EA, Naik AD, Berger DH, Suliburk JW. Mixed-methods analysis of factors impacting use of a postoperative mhealth app. JMIR Mhealth Uhealth. 2017;5(2):e11. [Crossref] [PubMed] [PMC] 
  53. Goh G, Tan NC, Malhotra R, Padmanabhan U, Barbier S, Allen JC Jr, et al. Short-term trajectories of use of a caloric-monitoring mobile phone app among patients with type 2 diabetes mellitus in a primary care setting. J Med Internet Res. 2015;17(2):e33. [Crossref] [PubMed] [PMC] 
  54. Caburnay CA, Graff K, Harris JK, McQueen A, Smith M, Fairchild M, et al. Evaluating diabetes mobile applications for health literate designs and functionality, 2014. Prev Chronic Dis. 2015;12:E61. [Crossref] [PubMed] [PMC] 

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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com