A systematic review of the effects of e‐health on chronically ill patients
Abstract
Aims and objectives. We aimed to investigate whether e‐health is equal to or better than usual face‐to‐face care with regard to outcomes on health, quality of life, patient satisfaction and costs. Therefore, we systematically reviewed the literature on e‐health in chronically ill patients compared with or as an addition to usual care. Background. Interactive websites on internet are increasingly used to inform and treat patients. This type of contact between patients and health care providers, which is called e‐health, is easily accessible and particularly interesting for chronically ill patients. Design. A systematic review. Methods. We searched the databases PubMed, CINAHL, the Cochrane Database of systematic reviews, DARE and CENTRAL for articles published between January 2000–July 2009. Results. The search strategy yielded in total 695 possibly relevant references, which resulted in 12 RCTs after application of the in‐ and exclusion criteria. Most of the studies were well designed according to the Cochrane criteria for RCTs. The studies are divided into e‐health vs. usual care and e‐health as addition to usual care. e‐Health consisted of monitoring, treatment instructions, self‐management training and general information and communication between patient and caregiver. Most of the studies showed small to moderate positive effects on health outcomes. Cost‐effectiveness, quality of life and patient satisfaction were rarely investigated in the included studies. Conclusions. e‐Health interventions for chronically ill patients, offered instead of usual care or in addition to usual care, lead to small to moderate positive effects on primary health outcomes. However, the evidence was not fully convincing, because of the limited number of studies available and the methodological limitations. Further research is needed to confirm the cost‐effectiveness of e‐health interventions for patients with chronic diseases. Relevance to clinical practice. e‐Health is a promising tool for treatment and self‐management training of chronically ill patients.
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Telecare products and services have the potential to alleviate this burden by supporting self-management, remote monitoring of health conditions, and delivery of interventions.
“Telecare products and services have the potential to alleviate this burden by supporting self-management, remote monitoring of health conditions, and the delivery of interventions [4-6].”
From Experiences of Multidisciplinary Development Team Members During User-Centered Design of Telecare Products and Services: A Qualitative Study (2014) · cites this paper as [5]
Narrative syntheses showed modest benefit in telehealth interventions both in place of and supplementing usual care.
“Narrative syntheses showed mixed results, with modest benefit in telehealth interventions both in place of and supplementing usual care [37], little evidence of benefit from telehealth interventions that excluded telephone support [28], and positive results for telehealth-delivered behavioral interventions (n=13 RCTs) [22].”
Eight mixed diabetes reviews were weighted 2 stars.
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
Four of the 2-star mixed diabetes reviews included meta-analyses of impact on HbA1c, with three showing significant improvements over controls.
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c.
“Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c [27,30,35-37,40,44-46].”
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- Authors
- Eland‐de Kok, P., van Os‐Medendorp, H., Vergouwe‐Meijer, A., Bruijnzeel‐Koomen, C., & Ros, W.
- Affiliations
- University Medical Center Utrecht (NL)
- ORCID
- Ros, Wynand
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2011-06-27
- Volume
- 20
- Issue
- 21-22
- Pages
- 2997-3010
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W1858955106
- Cited by
- 114
- References
- 40
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 2 · 2021: 6 · 2020: 8 · 2019: 8 · 2018: 14 · 2017: 7 · 2016: 13 · 2015: 13 · 2014: 11 · 2013: 9 · 2012: 6
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- e-health, chronic disease, online intervention, self-management education, quality of life, patient satisfaction, cost-effectiveness, usual care comparison, patient-provider communication, health outcomes
- MeSH terms
- Chronic Disease, Humans, Internet
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