scholarly journals Effectiveness of digital health interventions for diabetes: systematic review of systematic reviews

2021 ◽  
Author(s):  
Bonkana Maiga ◽  
Cheick O Bagayoko ◽  
Mohamed Ali Ag Ahmed ◽  
Abdrahamane Anne ◽  
Marie-Pierre Gagnon ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Digital Health ◽  
Scientific Evidence ◽  
Relevant Information ◽  
Health Interventions ◽  
Care Utilization ◽  
Clinical Indicators ◽  
Health Technologies ◽  
Digital Interventions ◽  
Effective Interventions

Abstract Background The use of digital health technologies to tackle diabetes has been particularly flourishing in recent years. Previous studies have shown to varying degrees that these technologies can have an impact on diabetes prevention and management. Objective The aim of this review is to summarize the best evidence regarding the effectiveness of digital health interventions to improve one or more diabetes indicators. Methods We included all types of interventions aimed at evaluating the effect of digital health on diabetes. We considered at all types of digital interventions (mobile health, teleconsultations, tele-expertise, electronic health records, decision support systems, e-learning, etc.). We included systematic reviews published in English or French over the last 29 years, from January 1991 to December 2019, that met the inclusion criteria. Two reviewers independently reviewed the titles and abstracts of the studies to assess their eligibility, and extracted relevant information according to a predetermined grid. Any disagreement was resolved by discussion and consensus between the two reviewers, or involved a third author as referee. Results In total in our review of journals, we included 10 reviews. The outcomes of interest were clinical indicators of diabetes that could be influenced by digital interventions. These outcomes had to be objectively measurable indicators related to diabetes surveillance and management that are generally accepted by diabetes experts. Six of the ten reviews showed moderate to large significant reductions in glycated hemoglobin (HBA1c) levels compared to controls. Most reviews reported overall positive results and found that digital health interventions improved health care utilization, behaviours, attitudes, knowledge and skills. Conclusion Based on a large corpus of scientific evidence on digital health interventions, this overview could help identify the most effective interventions to improve diabetes indicators.

scholarly journals Using digital interventions to improve the cardiometabolic health of populations: a meta-review of reporting quality

2017 ◽  
Vol 24 (4) ◽  
pp. 867-879 ◽  
Author(s):  
Adrienne O’Neil ◽  
Fiona Cocker ◽  
Patricia Rarau ◽  
Shaira Baptista ◽  
Mandy Cassimatis ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Digital Health ◽  
Reporting Quality ◽  
Health Interventions ◽  
Health Programs ◽  
Quality Of Reporting ◽  
Digital Interventions ◽  
Meta Review ◽  
Research Findings

Abstract Objectives. We conducted a meta-review to determine the reporting quality of user-centered digital interventions for the prevention and management of cardiometabolic conditions. Materials and Methods. Using predetermined inclusion criteria, systematic reviews published between 2010 and 2015 were identified from 3 databases. To assess whether current evidence is sufficient to inform wider uptake and implementation of digital health programs, we assessed the quality of reporting of research findings using (1) endorsement of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, (2) a quality assessment framework (eg, Cochrane risk of bias assessment tool), and (3) 8 parameters of the Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth (CONSORT-eHEALTH) guidelines (developed in 2010). Results. Of the 33 systematic reviews covering social media, Web-based programs, mobile health programs, and composite modalities, 6 reported using the recommended PRISMA guidelines. Seven did not report using a quality assessment framework. Applying the CONSORT-EHEALTH guidelines, reporting was of mild to moderate strength. Discussion. To our knowledge, this is the first meta-review to provide a comprehensive analysis of the quality of reporting of research findings for a range of digital health interventions. Our findings suggest that the evidence base and quality of reporting in this rapidly developing field needs significant improvement in order to inform wider implementation and uptake. Conclusion. The inconsistent quality of reporting of digital health interventions for cardiometabolic outcomes may be a critical impediment to real-world implementation.

scholarly journals The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia J. Lucas ◽  
Alastair D. Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Social Resources ◽  
Health Interventions ◽  
Structured Interviews ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract Background Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aims To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups. Methods A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically. Results A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender. Conclusion This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

scholarly journals Digital health interventions in palliative care: a systematic meta-review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Hannah O’Donnell ◽  
Jean Lugton ◽  
Tilly Gibson-Watt ◽  
Connie Swenson ◽  
...  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Systematic Reviews ◽  
Psychological Symptoms ◽  
Digital Health ◽  
Evidence Synthesis ◽  
Information Provision ◽  
Health Interventions ◽  
Meta Review

AbstractDigital health interventions (DHIs) have the potential to improve the accessibility and effectiveness of palliative care but heterogeneity amongst existing systematic reviews presents a challenge for evidence synthesis. This meta-review applied a structured search of ten databases from 2006 to 2020, revealing 21 relevant systematic reviews, encompassing 332 publications. Interventions delivered via videoconferencing (17%), electronic healthcare records (16%) and phone (13%) were most frequently described in studies within reviews. DHIs were typically used in palliative care for education (20%), symptom management (15%), decision-making (13%), information provision or management (13%) and communication (9%). Across all reviews, mostly positive impacts were reported on education, information sharing, decision-making, communication and costs. Impacts on quality of life and physical and psychological symptoms were inconclusive. Applying AMSTAR 2 criteria, most reviews were judged as low quality as they lacked a protocol or did not consider risk of bias, so findings need to be interpreted with caution.

scholarly journals Digital Interventions to Support Adolescents and Young Adults With Cancer: Systematic Review

JMIR Cancer ◽  
10.2196/12071 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e12071 ◽  
Author(s):  
Lisa McCann ◽  
Kathryn Anne McMillan ◽  
Gemma Pugh
Keyword(s):  
Young Adults ◽  
Cancer Diagnosis ◽  
Subjective Experience ◽  
Emotional Health ◽  
Digital Health ◽  
Health Interventions ◽  
Adolescents And Young Adults ◽  
Research Papers ◽  
Digital Interventions ◽  
Diagnosis Of Cancer

Background The last decade has seen an increase in the number of digital health interventions designed to support adolescents and young adults (AYAs) with cancer. Objective The objective of this review was to identify, characterize, and fully assess the quality, feasibility, and efficacy of existing digital health interventions developed specifically for AYAs, aged between 13 and 39 years, living with or beyond a cancer diagnosis. Methods Searches were performed in PubMed, EMBASE, and Web of Science to identify digital health interventions designed specifically for AYA living with or beyond a cancer diagnosis. Data on the characteristics and outcomes of each intervention were synthesized. Results A total of 4731 intervention studies were identified through the searches; 38 interventions (43 research papers) met the inclusion criteria. Most (20/38, 53%) were website-based interventions. Most studies focused on symptom management and medication adherence (15, 39%), behavior change (15, 39%), self-care (8, 21%), and emotional health (7, 18%). Most digital health interventions included multiple automated and communicative functions such as enriched information environments, automated follow-up messages, and access to peer support. Where reported (20, 53% of studies), AYAs’ subjective experience of using the digital platform was typically positive. The overall quality of the studies was found to be good (mean Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields scores >68%). Some studies reported feasibility outcomes (uptake, acceptability, and attrition) but were not sufficiently powered to comment on intervention effects. Conclusions Numerous digital interventions have been developed and designed to support young people living with and beyond a diagnosis of cancer. However, many of these interventions have yet to be deployed, implemented, and evaluated at scale.

The impact of digital interventions on antimicrobial stewardship in hospitals: A qualitative synthesis of systematic reviews (Preprint)

2021 ◽  
Author(s):  
Bethany A Van Dort ◽  
Jonathan Penm ◽  
Angus Ritchie ◽  
Melissa T Baysari
Keyword(s):  
Systematic Reviews ◽  
Antimicrobial Stewardship ◽  
Digital Health ◽  
Hospital Setting ◽  
Antimicrobial Use ◽  
Qualitative Synthesis ◽  
Large Variability ◽  
Antimicrobial Prescribing ◽  
Digital Interventions ◽  
The Impact

BACKGROUND Antimicrobial stewardship (AMS) programs aim to optimize antimicrobial use by utilizing a suite of coordinated strategies. With the increased use of health information technology in hospitals, AMS processes that were traditionally paper-based are becoming computerized and streamlined. A number of reviews on digital interventions supporting AMS have been performed, so we performed a review of reviews to consolidate findings OBJECTIVE To provide a systematic overview and synthesis of evidence on the effectiveness of digital interventions to improve antimicrobial prescribing and monitoring in hospitals. METHODS Databases: Medline, Embase, Scopus, CINAHL and the Cochrane Database of Systematic Reviews were searched from 2010 onwards. Papers were eligible if they included studies that examined the effectiveness of digital health interventions related to antimicrobial prescribing and monitoring, in an inpatient hospital setting. Papers were excluded if they did not include a clearly defined search strategy, if they were limited to a pediatric setting, or they were not in English. RESULTS Seven systematic reviews were included for data extraction. Five reviews were of moderate quality and two of low quality. A large number of digital interventions were evaluated, with a strong focus on clinical decision support. There was a large variability in outcome measures used. Six reviews reported that digital interventions reduced antimicrobial use and improved antimicrobial appropriateness. The impact of digital interventions on clinical outcomes was inconsistent. CONCLUSIONS The results of this review indicate digital interventions, regardless of type, reduce antimicrobial use and improve antimicrobial appropriateness in hospitals. We recommend hospitals consider implementing one or more digital interventions to facilitate AMS programs.

scholarly journals A Tutorial on the Challenges and Solutions for Developing Tailored Video Interventions that Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: The Positive Health Check Example (Preprint)

2020 ◽  
Author(s):  
Camilla Harshbarger ◽  
Olivia Burrus ◽  
Sivakumar Rangarajan ◽  
John Bollenbacher ◽  
Brittany Zulkiewicz ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Interventions ◽  
Health Check ◽  
Multidisciplinary Teams ◽  
Positive Health ◽  
Counseling Intervention ◽  
Video Clips ◽  
Tailored Messages ◽  
Digital Interventions ◽  
Digital Assets

UNSTRUCTURED Video is a versatile and popular medium for digital health interventions and as the technology behind mobile devices and applications advances, video-based interventions may become increasingly common. Though a complex and busy environment, clinic waiting rooms offer the opportunity for implementing digital interventions to patients waiting to see their providers. However, to increase efficient ways of working in public health, to leverage the scalability and low cost of implementing digital interventions, and to keep up with rapidly advancing technology and user needs, more guidance is needed on the design and development of video-based tailored interventions. Here we provide a tutorial for digital intervention researchers and developers who wish to efficiently design and develop video-based, tailored, digital health interventions by describing our challenges and solutions encountered with Positive Health Check (PHC). PHC, a hybrid app, is a brief, interactive, individually- tailored video-based digital HIV behavioral counseling intervention. Hybrid applications are available from an Internet URL or can be downloaded from Google Play and the Apple Store. PHC uses video clips, and multimedia digital assets to deliver intervention content. These include interactive, tailored messages and graphics, a repurposed animated video and patient and provider handouts generated in real-time by PHC. This tutorial addresses numerous challenges and solutions for (1) using video as a medium to enhance user engagement through “video doctors”, full screen video, storyboards and streamlined scripts; (2) navigating the complexity of linking a database of video clips with other digital assets through script coding and flow diagrams of algorithms for delivering a tailored user experience; and, (3) identifying main steps to building an app that will seamlessly deliver to users individually-tailored messages, graphics and handouts. These steps include using keyframes to design integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven backend solution that will tailor message delivery to individual users. Although PHC focuses on promoting health and well-being among persons with HIV, the challenges and solutions presented here are transferable to video-based digital health interventions focused on other areas of health.

scholarly journals The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

2020 ◽  
Author(s):  
Sophie Turnbull ◽  
Patricia Lucas ◽  
Alastair D Hay ◽  
Christie Cabral
Keyword(s):  
Social Networks ◽  
Social Status ◽  
Digital Health ◽  
Self Care ◽  
Social Resources ◽  
Health Interventions ◽  
Structured Interviews ◽  
Health Technologies ◽  
Digital Skills ◽  
Care Support

Abstract BackgroundType 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aimsTo gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.MethodsA purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.ResultsA diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.ConclusionThis research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

scholarly journals A Primer on Usability Assessment Approaches for Health-Related Applications of Virtual Reality (Preprint)

2020 ◽  
Author(s):  
Timothy Zhang ◽  
Richard Booth ◽  
Royce Jean-Louis ◽  
Ryan Chan ◽  
Anthony Yeung ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Professional Training ◽  
Digital Health ◽  
Usability Testing ◽  
Relevant Information ◽  
Medical Professional ◽  
Patient Treatment ◽  
Health Technologies ◽  
Starting Point ◽  
Health Related

UNSTRUCTURED Health-related virtual reality (VR) applications for patient treatment, rehabilitation, and medical professional training are on the rise. However, there is little guidance on how to select and perform usability evaluations for VR health interventions compared to the supports that exist for other digital health technologies. The purpose of this viewpoint paper is to present an introductory summary of various usability testing approaches or methods that can be used for VR applications. Along with an overview of each, a list of resources is provided for readers to obtain additionally relevant information. Six categories of VR usability evaluations are described using a previously developed classification taxonomy specific to VR environments: (1) cognitive or task walkthrough, (2) graphical evaluation, (3) post hoc questionnaires or interviews, (4) physical performance evaluation, (5) user interface evaluation, and (6) heuristic evaluation. Given the growth of VR in health care, rigorous evaluation and usability testing is crucial in the development and implementation of novel VR interventions. The approaches outlined in this paper provide a starting point for conducting usability assessments for health-related VR applications; however, there is a need to also move beyond these to adopt those from the gaming industry, where assessments for both usability and user experience are routinely conducted.

scholarly journals Mobile safety alarms based on global positioning system technology in elderly care: a systematic review of evidence based on a general evidence framework for digital health technologies (Preprint)

2021 ◽  
Author(s):  
Maria Ehn ◽  
Matt X Richardson ◽  
Sara Landerdahl Stridsberg ◽  
W. Ken Redekop ◽  
Sarah Wamala-Andersson
Keyword(s):  
Global Positioning System ◽  
Systematic Reviews ◽  
Social Care ◽  
Digital Health ◽  
Elderly Care ◽  
Grey Literature ◽  
Health Technologies ◽  
Tier 1 ◽  
Global Positioning ◽  
Standard Framework

BACKGROUND Global Positioning System (GPS) alarms aim at supporting users in independent daily indoor and outdoor activities. GPS alarms are implemented in social care, particularly in Nordic countries. Previous systematic reviews report lack of clear evidence of the effectiveness of GPS alarms on the health and welfare of users and their families, as well as social care provision. Evidence on effectiveness can support informed decision on implementation of health and welfare technologies. Standardized evidence frameworks have been developed to ensure that new technologies are clinically effective and offer economic value. However, systematic reviews seldom assess identified evidence using the frameworks. OBJECTIVE This study provides an up-to-date systematic review on evidence from existing studies of GPS-based alarms’ effects on health, welfare and social provision in elderly care, compared to non-GPS standard care. Moreover, the study findings are assessed against the evidence standard framework for digital health technologies (DHTs) established by the National Institute for Health and Care Excellence (NICE) in UK. METHODS The review was conducted according to recommended guidelines. Primary studies published in peer-reviewed and grey literature between January 2005 and August 2020 were identified through searches in 13 databases and several sources of grey literature. Articles were included if the studied population was persons 50 years and older, who either received social care for elderly or social care for persons with dementia; employed GPS devices that enabled the users to initiate alarms and/or localization of user position and/or geofencing functions as an intervention; were performed in Canada, US, EU, Singapore, Australia, New Zealand, Hong Kong, South Korea, or Japan; and addressed outcomes related to health, welfare and social care outcomes by use of quantitative methods. Study findings were categorized and summarized according to the requirements for “active monitoring” DHTs (i.e. tier 3b) of the NICE evidence standard framework. RESULTS 16 of the 986 screened records met the eligibility criteria. 7 peer-reviewed publications and 9 grey literature studies contributed with information. Best practice evidence was identified according to standards for tier 1 category “Relevance to current pathways in health/social care system” and minimum standard evidence was identified according to standards for tier 1 category “Credibility with health, social care professionals” of the NICE framework. However, several evidence categories in tiers 1 and 2 could not be assessed and no clear evidence demonstrating effectiveness in outcomes or improvements in outcomes could be identified. The evidence required for DHTs tracking patient location (tier 3b) in the NICE framework was therefore insufficient. CONCLUSIONS The evidence in current grey and peer-reviewed literature for GPS-based mobile alarms’ beneficial effects on health and welfare of older adults and social care provision is insufficient. Future research should utilize knowledge produced in previous studies and systematic reviews. CLINICALTRIAL Not required, no primary study.

scholarly journals The Effectiveness of Digital Health Interventions in the Management of Musculoskeletal Conditions: Systematic Literature Review

10.2196/15617 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15617 ◽  
Author(s):  
Stephanie Hewitt ◽  
Ruth Sephton ◽  
Gillian Yeowell
Keyword(s):  
Systematic Reviews ◽  
Functional Disability ◽  
Resource Constraints ◽  
Digital Health ◽  
Health Interventions ◽  
Medical Subject Headings ◽  
Economic Implications ◽  
Musculoskeletal Conditions ◽  
Large Patient ◽  
Individual Economy

Background Musculoskeletal conditions are the second greatest contributor to disability worldwide and have significant individual, societal, and economic implications. Due to the growing burden of musculoskeletal disability, an integrated and strategic response is urgently required. Digital health interventions provide high-reach, low-cost, readily accessible, and scalable interventions for large patient populations that address time and resource constraints. Objective This review aimed to investigate if digital health interventions are effective in reducing pain and functional disability in patients with musculoskeletal conditions. Methods A systematic review was undertaken to address the research objective. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol was registered with the International Prospective Register of Systematic Reviews before commencement of the study. The following databases were searched: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature, and Scopus from January 1, 2000, to November 15, 2019, using search terms and database specific−medical subject headings terms in various combinations appropriate to the research objective. Results A total of 19 English language studies were eligible for inclusion. Of the 19 studies that assessed musculoskeletal pain, 9 reported statistically significant reductions following digital intervention. In all, 16 studies investigated functional disability; 10 studies showed a statistically significant improvement. Significant improvements were also found in a range of additional outcomes. Due to the heterogeneity of the results, a meta-analysis was not feasible. Conclusions This review has demonstrated that digital health interventions have some clinical benefits in the management of musculoskeletal conditions for pain and functional disability. Digital health interventions have the potential to contribute positively toward reducing the multifaceted burden of musculoskeletal conditions to the individual, economy, and society. Trial Registration PROSPERO CRD42018093343; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=93343

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