Scoping Review of Information and Communication-Technology to Support Patients and Health Care Providers in Person Centered Care Management of Chronic Diseases

SE Wildevuur, LWL Simonse

    Research output: Chapter in Book/Conference proceedings/Edited volumeConference contributionScientificpeer-review

    Abstract

    Background: Information and communication-technology (ICT) could involve patients to take an active part in their care and decision-making process, and make it possible for patients to interact directly with healthcare providers and services about personal health concerns. Yet, little is known about which ICT-interventions dedicated to connected care interactions and person centered care (PCC) are studied, in particular with respect to shared care management of chronic diseases. The aim of this research is to investigate the extent, range and nature of these research activities and identify research gaps in the existing evidence base of health studies regarding diabetes mellitus (type I and II), cardiovascular and chronic respiratory diseases.
    Objective: The objective of this paper is to review the literature and scope the field with respect to: Which ICT-interventions have been studied to support patients and healthcare professionals in PCC-management of the 'big five' of chronic diseases?, and: What is the impact of these interventions, such as Health Related Quality of Life and costs benefits?
    Methods: This research adopts a scoping review method, employing the methodological framework of Arksey and O’Malley’s (2005) with five stages of systematic and rigorous literature review. Three electronic medical databases were accessed: PubMed, Medline and Cochrane Library. After (1) Identifying the research question, we continued with (2) Identifying relevant studies in the three databases by a comprehensive composed search syntax; (3) Study selection with discussed and outlined inclusion and exclusion criteria by two reviewers; (4) Charting the data and finally (5) Collating, summarizing and reporting the results.
    Results: From the initial 9380 search results, we identified 200 studies that qualified for inclusion: diabetes mellitus (type I and II) (n=78), cardiovascular diseases (n=65) and chronic respiratory diseases (n=57). First, most of the personalised ICT-interventions are used for activities of self-measurement of the body with the highest ranking in chronic respiratory diseases (65%), followed by cardiovascular (63%) with high tech implant monitoring devices. Second, telemedicine is not always internet-based, but starts with low tech telephone interventions as reported in about one fifth of the studies. Third, the impact of the connected care interventions relates to patient’s improvements of: physical condition (19%), Health Related Quality of Life (13%) and empowerment and education (15%). Fourth, 13% of the studies reported an increase in clinical outcomes, with the highest ranking for cardiovascular diseases (7%). Fifth, the impact of the connected care interventions relates to organisational outcomes: Hospitalisation decrease (14%) and Cost efficiency (9%). Negative outcomes were also reported: HRQL decrease (8%) and cost efficiency decrease (2%).
    Conclusion: This scoping review has outlined different types of ICT-interventions, for each type of chronic care management to support patients to take an active part in their care and decision-making process, and make it possible to interact directly with healthcare providers and services about personal health concerns. Hardly any of the ICT-interventions could be regarded as ‘fully’ person centered care. This review will be especially helpful to those deciding on areas where further development into research or implementation of ICT for PCC may be warranted.
    Original languageEnglish
    Title of host publicationMedicine 2.0
    Subtitle of host publicationSummit & World Congress
    Place of PublicationMaui, Hawaii, USA
    PublisherMedicine 2.0
    Pages1
    Number of pages27
    VolumeNovember 12-15
    Edition'14
    Publication statusPublished - 13 Nov 2014

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