Abstract
Background/aims: Prevalence of multimorbidity is increasing in ageing populations. It increases the risk of poor quality of life and mortality, and places additional strain on healthcare. Digital technology can potentially improve the access and quality of health services for this population. This study aimed to appraise the evidence for the effectiveness of digital technology among patients with multimorbidity, and user experience.
Methods: A mixed-methods systematic review was conducted on four databases for studies published in English (2000- 2022). Studies were included if they were original research focusing on patient outcomes and/or economic evaluation of digital technology for multimorbid patients. Data were synthesised narratively.
Results: 15 (8 quantitative, 7 qualitative) studies were retained. Six were RCTs, five of which integrated digital interventions into usual care. Digital technology significantly improved exercise capacity (6-min walk test 60m vs -15m, P=0.004), dyspnoea (−0.17 vs 0.07, P=0.05), physical activity profile (18.1 vs −21.3, P=0.0015), disability (5.4 vs 1.3, P=0.0006), quality of life (−10.5 vs −0.44, P=0.0007), and reduced rehospitalisation (HR, 0.42; 95%CI, 0.27-0.64; P<0.001). It also improved medication adherence (p<.001) and reduced missed doses of medication (p=.02) and medication errors (p<.001). One study showed that digital technology improved the quality of life of type 2 diabetes and coronary artery disease patients with moderate costs in the short-term follow-up. For most participants, e-Health services were acceptable to improve self management and enhance care experience. Ensuring effective engagement and its usability required training and support from healthcare providers.
Conclusions: Digital technology has the potential to provide self-management support for people with multimorbidity. This review provides important insights to use eHealth solutions for self-managing symptoms and medication.
Funder: Burdett Trust for Nursing
PROSPERO: CRD42022347612
Methods: A mixed-methods systematic review was conducted on four databases for studies published in English (2000- 2022). Studies were included if they were original research focusing on patient outcomes and/or economic evaluation of digital technology for multimorbid patients. Data were synthesised narratively.
Results: 15 (8 quantitative, 7 qualitative) studies were retained. Six were RCTs, five of which integrated digital interventions into usual care. Digital technology significantly improved exercise capacity (6-min walk test 60m vs -15m, P=0.004), dyspnoea (−0.17 vs 0.07, P=0.05), physical activity profile (18.1 vs −21.3, P=0.0015), disability (5.4 vs 1.3, P=0.0006), quality of life (−10.5 vs −0.44, P=0.0007), and reduced rehospitalisation (HR, 0.42; 95%CI, 0.27-0.64; P<0.001). It also improved medication adherence (p<.001) and reduced missed doses of medication (p=.02) and medication errors (p<.001). One study showed that digital technology improved the quality of life of type 2 diabetes and coronary artery disease patients with moderate costs in the short-term follow-up. For most participants, e-Health services were acceptable to improve self management and enhance care experience. Ensuring effective engagement and its usability required training and support from healthcare providers.
Conclusions: Digital technology has the potential to provide self-management support for people with multimorbidity. This review provides important insights to use eHealth solutions for self-managing symptoms and medication.
Funder: Burdett Trust for Nursing
PROSPERO: CRD42022347612
| Original language | English |
|---|---|
| Pages (from-to) | 65-66 |
| Number of pages | 2 |
| Journal | Palliative Medicine |
| Volume | 37 |
| Issue number | 1S |
| DOIs | |
| Publication status | Published - 7 Jun 2023 |
| Event | 18th EAPC World Congress - Rotterdam, Netherlands Duration: 15 Jun 2023 → 17 Jun 2023 |
