Nurse-led remote digital support for adults with chronic conditions: A systematic synthesis without meta-analysis.
Alicia Kilfoy, Charlene Chu, Archanaa Krisnagopal and 6 others
PMID 38894583WHAT IT FOUND
Nurse-led digital support improved patient satisfaction and self-management, but had limited impact on hard clinical outcomes like blood pressure or hospital admissions.
Mobile apps and frequent nurse contact appeared most effective, though study quality was often low.
Key findings
01Satisfaction with care improved in 66% of studies, and depression scores improved in 78%, but hospital admissions decreased in only 22% of assessments.
02Mobile applications were the most effective delivery method, significantly improving 64% of measured outcomes, compared to 30-47% for other digital tools.
03Objective clinical measures like HbA1c and blood pressure showed inconsistent results, improving in only 50% and 40% of studies respectively.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
60% of the included studies were rated as having a high risk of bias, primarily due to lack of blinding and high participant dropout rates. The review could not perform a meta-analysis due to the high variability in interventions and outcomes, limiting the ability to give a single pooled effect size. Most studies were conducted in high-income countries and targeted younger adults, so findings may not apply to older populations or low-resource settings. The search was limited to English-language publications, potentially missing relevant global evidence.
Declared interests
The authors declared no conflicts of interest, and the study received no specific funding.
The easy way to misread this
Do not assume nurse-led digital monitoring automatically reduces hospital readmissions or improves physiological markers like blood pressure. The review found these objective outcomes improved in only 22-40% of assessments, and the high risk of bias in many studies means these null or weak findings should be interpreted with caution.