Information and communication technology-enabled person-centered care for the "big five" chronic conditions: scoping review

Sabine E Wildevuur, Lianne W L Simonse, Sabine E Wildevuur, Lianne W L Simonse

Abstract

Background: Person-centered information and communication technology (ICT) could encourage patients to take an active part in their health care and decision-making process, and make it possible for patients to interact directly with health care providers and services about their personal health concerns. Yet, little is known about which ICT interventions dedicated to person-centered care (PCC) and connected-care interactions have been studied, especially for 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 evidence base of health studies regarding the "big 5" chronic diseases: diabetes mellitus, cardiovascular disease, chronic respiratory disease, cancer, and stroke.

Objective: The objective of this paper was to review the literature and to scope the field with respect to 2 questions: (1) which ICT interventions have been used to support patients and health care professionals in PCC management of the big 5 chronic diseases? and (2) what is the impact of these interventions, such as on health-related quality of life and cost efficiency?

Methods: This research adopted a scoping review method. Three electronic medical databases were accessed: PubMed, EMBASE, and Cochrane Library. The research reviewed studies published between January 1989 and December 2013. In 5 stages of systematic scanning and reviewing, relevant studies were identified, selected, and charted. Then we collated, summarized, and reported the results.

Results: From the initial 9380 search results, we identified 350 studies that qualified for inclusion: diabetes mellitus (n=103), cardiovascular disease (n=89), chronic respiratory disease (n=73), cancer (n=67), and stroke (n=18). Persons with one of these chronic conditions used ICT primarily for self-measurement of the body, when interacting with health care providers, with the highest rates of use seen in chronic respiratory (63%, 46/73) and cardiovascular (53%, 47/89) diseases. We found 60 relevant studies (17.1%, 60/350) on person-centered shared management ICT, primarily using telemedicine systems as personalized ICT. The highest impact measured related to the increase in empowerment (15.4%, 54/350). Health-related quality of life accounted for 8%. The highest impact connected to health professionals was an increase in clinical outcome (11.7%, 41/350). The impacts on organization outcomes were decrease in hospitalization (12.3%, 43/350) and increase of cost efficiency (10.9%, 38/350).

Conclusions: This scoping review outlined ICT-enabled PCC in chronic disease management. Persons with a chronic disease could benefit from an ICT-enabled PCC approach, but ICT-PCC also yields organizational paybacks. It could lead to an increase in health care usage, as reported in some studies. Few interventions could be regarded as "fully" addressing PCC. This review will be especially helpful to those deciding on areas where further development of research or implementation of ICT-enabled PCC may be warranted.

Keywords: cardiovascular diseases; chronic disease; chronic respiratory tract diseases; decision making; diabetes mellitus; disease management; eHealth; neoplasms; patient-centered care; person-centered care; self-care; stroke; telemedicine.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Search and screening results.
Figure 2
Figure 2
Number of studies conducted over the years for the “big five” chronic conditions.

References

    1. World Health Organization. Alwan A. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011. .
    1. Huber M, Knottnerus JA, Green L, Horst HVD, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro Mi, Meer Jwmvd, Schnabel P, Smith R, Weel CV, Smid H. How should we define health? BMJ. 2011 Jul 26;343(jul26 2):d4163–d4163. doi: 10.1136/bmj.d4163.
    1. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002 Nov 20;288(19):2469–75.
    1. Frost J, Massagli M. PatientsLikeMe the case for a data-centered patient community and how ALS patients use the community to inform treatment decisions and manage pulmonary health. Chron Respir Dis. 2009;6(4):225–9. doi: 10.1177/1479972309348655.
    1. Eysenbach G, Powell J, Englesakis M, Rizo C, Stern A. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ. 2004 May 15;328(7449):1166. doi: 10.1136/bmj.328.7449.1166.
    1. World Health Organization Western Pacific Region . People-centred health care: A policy framework. Geneva: World Health Organization; 2007. [2015-03-08]. .
    1. Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, Carlsson J, Dahlin-Ivanoff S, Johansson I-L, Kjellgren K, Lidén E, Öhlén J, Olsson L-E, Rosén H, Rydmark M, Sunnerhagen KS. Person-centered care--ready for prime time. Eur J Cardiovasc Nurs. 2011 Dec;10(4):248–51. doi: 10.1016/j.ejcnurse.2011.06.008.
    1. Ekman I, Britten N, Bordin J, Codagnone C, Eden S, Forslund D, Fredman P, Grip L, Hedman H, Hesselbom T, Hard I, Larko O, Lindstrom I, Lindstrom L, Norberg A, Olauson A, Rosen H, Seddigh A, Tennant A, Westerteicher C, Alsnas B, Swedberg K. The person-centred approach to an ageing society. EJPCH. 2013 Jun 11;1(1):132–7. doi: 10.5750/ejpch.v1i1.644.
    1. Ekman I, Wolf A, Olsson L-E, Taft C, Dudas K, Schaufelberger M, Swedberg K. Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. Eur Heart J. 2012 May;33(9):1112–9. doi: 10.1093/eurheartj/ehr306.
    1. Olsson L-E, Karlsson J, Ekman I. The integrated care pathway reduced the number of hospital days by half: a prospective comparative study of patients with acute hip fracture. J Orthop Surg Res. 2006;1:3. doi: 10.1186/1749-799X-1-3.
    1. Olsson L-E, Jakobsson UE, Swedberg K, Ekman I. Efficacy of person-centred care as an intervention in controlled trials - a systematic review. J Clin Nurs. 2013 Feb;22(3-4):456–65. doi: 10.1111/jocn.12039.
    1. van Meeuwen DPD, van Walt Meiijer QJ, Simonse LWL. Care models of eHealth services: A case study on the Design of a Business Model for an Online Precare Service. J Med Internet Res Protoc. 2015;4(1):e32. doi: 10.2196/resprot.3501.
    1. Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):E20. doi: 10.2196/jmir.3.2.e20.
    1. Paré G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: the evidence base. Journal of the American Medical Informatics Association. 2007;14(3):269–77. doi: 10.1197/jamia.M2270.
    1. Fiordelli M, Diviani N, Schulz PJ. Mapping mHealth research: a decade of evolution. J Med Internet Res. 2013;15(5):e95. doi: 10.2196/jmir.2430.
    1. Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, Nolan RP. Reducing blood pressure with Internet-based interventions: a meta-analysis. Can J Cardiol. 2013 May;29(5):613–21. doi: 10.1016/j.cjca.2013.02.007.
    1. Aarts JWM, van den Haak P, Nelen WLDM, Tuil WS, Faber MJ, Kremer JAM. Patient-focused internet interventions in reproductive medicine: a scoping review. Hum Reprod Update. 2012 Apr;18(2):211–27. doi: 10.1093/humupd/dmr045.
    1. Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. N Engl J Med. 2012 Mar 1;366(9):780–1. doi: 10.1056/NEJMp1109283.
    1. International College of Person-Centered Medicine Geneva Declaration on Person-centered Care for Chronic Diseases. The International Journal of Person Centered Medicine. 2012;2:153–4. doi: 10.5750/2Fijpcm.v2i2.206.
    1. Anderson S, Allen P, Peckham S, Goodwin N. Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services. Health Res Policy Syst. 2008;6:7. doi: 10.1186/1478-4505-6-7.
    1. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):1–9. doi: 10.1186/1748-5908-5-69.
    1. Arksey HOML, O'Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005 Feb;8(1):19–32. doi: 10.1080/1364557032000119616.
    1. Gruman J, Rovner MH, French ME, Jeffress D, Sofaer S, Shaller D, Prager DJ. From patient education to patient engagement: implications for the field of patient education. Patient Educ Couns. 2010 Mar;78(3):350–6. doi: 10.1016/j.pec.2010.02.002.
    1. Eysenbach G. Medicine 2.0: social networking, collaboration, participation, apomediation, and openness. JMIR. 2008;10(3):22. doi: 10.2196/jmir.1030.
    1. Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS medicine. 2013;10(1):1001362. doi: 10.1371/journal.pmed.1001363.
    1. van Gemert-Pijnen JE, Nijland N, van Limburg M, Ossebaard HC, Kelders SM, Eysenbach G, Seydel ER. A holistic framework to improve the uptake and impact of eHealth technologies. J Med Internet Res. 2011;13(4):e111. doi: 10.2196/jmir.1672.
    1. Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed J E Health. 2009 Apr;15(3):231–40. doi: 10.1089/tmj.2008.0099.
    1. Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Légaré F, Thomson R. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2011;(10):CD001431. doi: 10.1002/14651858.CD001431.pub3.
    1. Verhoeven F, Tanja-Dijkstra K, Nijland N, Eysenbach G, van Gemert-Pijnen L. Asynchronous and synchronous teleconsultation for diabetes care: a systematic literature review. J Diabetes Sci Technol. 2010 May;4(3):666–84.
    1. García-Lizana F, Sarría-Santamera A. New technologies for chronic disease management and control: a systematic review. J Telemed Telecare. 2007;13(2):62–8. doi: 10.1258/135763307780096140.
    1. Nijland N, van Gemert-Pijnen J, Boer H, Steehouder MF, Seydel ER. Evaluation of internet-based technology for supporting self-care: problems encountered by patients and caregivers when using self-care applications. J Med Internet Res. 2008;10(2):e13. doi: 10.2196/jmir.957.
    1. Nickels A, Dimov V. Innovations in technology: social media and mobile technology in the care of adolescents with asthma. Current Allergy Asthma Report. 2012 Dec 01;12(6):607–12. doi: 10.1007/s11882-012-0299-7.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe