The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review
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BACKGROUND: In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. OBJECTIVE: The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. METHODS: A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. RESULTS: Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. CONCLUSIONS: The effect of asynchronous communication is not shown unequivocally in these studies. Patients seem to be interested in using email. Patients are willing to participate and are taking the initiative to discuss health issues with their providers. Additional testing of the effects of asynchronous communication on self-management in chronically ill patients is needed.
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Other reviews on conditions like rheumatoid arthritis, diabetes, and skin diseases are consistent with our finding of a significant reduction in hospitalization risk.
“Our study indicated a significant reduction in hospitalization risk, consistent with other reviews on conditions like rheumatoid arthritis, diabetes, and skin diseases [82-84].”
From Effectiveness and Acceptability of Asynchronous Digital Health in Asthma Care: Mixed Methods Systematic Review (2024) · cites this paper as [83]
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- Authors
- de Jong, C. C., Ros, W. J., & Schrijvers, G.
- Affiliations
- Utrecht University (NL)
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2014-01-16
- Volume
- 16
- Issue
- 1
- Pages
- e19
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3913926
- OpenAlex
- W2079278511
- Cited by
- 124
- References
- 45
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 13 · 2023: 8 · 2022: 10 · 2021: 8 · 2020: 17 · 2019: 6 · 2018: 12 · 2017: 13 · 2016: 12 · 2015: 15 · 2014: 1
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- asynchronous communication, patient-provider communication, chronic disease, self-management, electronic messaging, email, health behavior, health outcomes, patient satisfaction, self-efficacy, back pain, dyspnea, heart failure, diabetes mellitus, asthma, physician visits, usability
- MeSH terms
- Asthma, Chronic Disease, Communication, Diabetes Mellitus, Humans, Professional-Patient Relations, Health Behavior, Patient Satisfaction, Outcome Assessment, Health Care, Internet
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