Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies

Abstract

Objectives: To understand the experiences of patients and healthcare professionals (HCPs) using self-management digital interventions (DIs) for chronic physical health conditions.

Methods: A systematic search was conducted in 6 electronic databases. Qualitative studies describing users' experiences of self-management DIs were included, and authors' interpretations were synthesised using meta-ethnography.

Results: 30 papers met the inclusion criteria, covering a range of DIs and chronic conditions, including hypertension, asthma and heart disease. The review found that patients monitoring their health felt reassured by the insight this provided, and perceived they had more meaningful consultations with the HCP. These benefits were elicited by simple tele-monitoring systems as well as multifaceted DIs. Patients appeared to feel more reliant on HCPs if they received regular feedback from the HCP. HCPs focused mainly on their improved clinical control, and some also appreciated patients' increased understanding of their condition.

Conclusions: Patients using self-management DIs tend to feel well cared for and perceive that they adopt a more active role in consultations, whilst HCPs focus on the clinical benefits provided by DIs.

Practice implications: DIs can simultaneously support patient condition management, and HCPs' control of patient health. Tele-monitoring physiological data can promote complex behaviour change amongst patients.

Keywords: Digital; Interventions; Qualitative; Self-management.

Conflict of interest statement

Conflicts of interest

Elizabeth Murray is the Managing Director of HeLP Digital, a not-for-profit Community Interest Company which disseminates digital health interventions to the NHS. She has not, and will not, receive any remuneration for this work.

Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1

PRISMA 2009 flow diagram.

Fig. 2

Visual representation of the third order constructs.