New technologies for chronic disease management and control: a systematic review
Abstract
We conducted a systematic review of the clinical effectiveness of interventions using information and communication technologies (ICTs) for managing and controlling chronic diseases. Electronic databases were searched for randomized clinical trials that assessed the effectiveness of ICTs (except for those that included only telephone communication) and measured some clinical indicator. Information was reviewed and assessed independently by two researchers. Of the 950 clinical trials identified, 56 studies were identified for potential inclusion. Of those, 24 were finally included: 5 studies in asthma, 3 in hypertension, 1 in home telecare, 7 in diabetes, 6 in heart failure and 2 in prevention heart disease. Overall, ICT applications did not show an improvement in clinical outcomes, although no adverse effects were identified. However, ICTs used in the detection and follow up of cardiovascular diseases provided better clinical outcomes, mortality reduction and lower health services utilization. Systems used for improving education and social support were also shown to be effective. At present the evidence about the clinical benefits of ICTs for managing chronic disease is limited.
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Nineteen reviews included both type 1 and 2 diabetes in their analyses, or included RCTs that did not differentiate.
“In total, 19 reviews included both type 1 and 2 diabetes in their analyses, or included RCTs that did not differentiate [16,22,25,27,28,31,32,34-40,44,45,47,50,51].”
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.”
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.”
Narrative syntheses showed little evidence of benefit from telehealth interventions that excluded telephone support.
“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].”
Use of telehealth, without telephone support, showed no impact on health care utilization in a 2-star narrative synthesis of 6 RCTs.
“The use of telehealth, without telephone support, showed no impact on health care utilization in a 2-star weighted narrative synthesis of 6 RCTs [28].”
Eight reviews assessed the impact on asthma control through symptom scores, quality of life, or unscheduled health care.
“A total of 8 reviews assessed the impact on asthma control through symptom scores, quality of life, or unscheduled health care [20,24,27,28,36,61-63].”
Nine reviews analyzed telehealth interventions for heart failure.
“A total of 9 reviews analyzed telehealth interventions for heart failure [16,20,28,55-60].”
Three 1-star reviews, all with narrative syntheses, concluded that further evaluation was needed before conclusions could be reached.
“Three 1-star reviews, all with narrative syntheses, concluded that further evaluation was needed before conclusions could be reached [28,36,61], while 1 other, focused on mobile interventions in developing countries, found evidence for improved symptom scores in a single RCT [20].”
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Olsen, E., & Kraft, P. (2008) · Lecture notes in computer science · doi:10.1007/978-3-540-68504-3_24 · Cited by 4 · see citing works
A System Dynamics Approach to Modeling the Cost Elements of Chronic Disease Management Interventions
Dı́az, R., Tulpule, M., & Behr, J. G. (2011) · Cited by 4 · see citing works
Parreira, P., Bernardes, R. A., Santos‐Costa, P., Graveto, J., Ferreira, P. A. C., Salgueiro‐Oliveira, A., Sousa, L. B., Serambeque, B., Mónico, L. D. S. M., Kapun, M. M., et al. (2021) · Lecture notes in bioengineering · doi:10.1007/978-3-030-72567-9_23 · Cited by 3 · see citing works
- Authors
- García-Lizana, F., & Sarría-Santamera, A.
- Affiliations
- Agency for Health Technology Assessment, Institute of Health 'Carlos III', Madrid, Spain
- Agency for Health Technology Assessment, Institute of Health 'Carlos III', Madrid, Spain; Department of Social Medicine, University of Alcalá Faculty of Medicine, Alcalá de Henares, Spain
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2007-03-01
- Volume
- 13
- Issue
- 2
- Pages
- 62-68
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W2157911237
- Cited by
- 138
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 10 · 2014: 11 · 2013: 12 · 2012: 9
- FWCI
- 13.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (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 › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- information and communication technologies, chronic disease management, telemedicine, asthma, hypertension, diabetes mellitus, heart failure, cardiovascular disease, telehomecare, health education, social support, clinical effectiveness, health care utilization, mortality reduction
- MeSH terms
- Chronic Disease, Communications Media, Computer Communication Networks, Humans, Patient Care Planning, Patient Education as Topic, Self Care, Randomized Controlled Trials as Topic, Treatment Outcome, Patient Satisfaction, Telemedicine
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