Systematic Review of Technology-Based Interventions Targeting Chronically Ill Adults and Their Caregivers.
Elliane Irani, Atsadaporn Niyomyart, Ronald L Hickman
PMID 31941418WHAT IT FOUND
Across 19 technology-based programs, seven studies favored patient self-management behaviors and seven of nine favored patient quality of life.
Caregiver and relationship outcomes were mixed, and evidence was weak.
Key findings
01Seven studies reported better patient health behaviors with the technology-based interventions, while two heart failure self-care studies found nonsignificant differences.
02Patient quality of life improved or tended to improve in seven of nine studies, but caregiver quality of life improved in four of six studies and caregiver burden results conflicted.
03Interpersonal outcomes were mixed: three studies found no improvement over time, while one reported improvements mostly favoring patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were pilot or quasi-experimental designs. They are not strong evidence that the interventions work. Many studies had high or unclear risk of bias because randomization details, allocation concealment, and blinding were often missing. Control groups varied widely, including usual care, wait list, attention control, and other conditions. This made it hard to know what the technology added. Studies used convenient sampling and very different chronic conditions, outcomes, intervention doses, and technologies. Results cannot be combined into one clear conclusion. Four studies reported only feasibility or acceptability, without health outcomes. The review used a narrative synthesis and reported only the significance found by each study. It could not determine which components caused the effects.
Declared interests
The authors declared no conflicts of interest. The publication types indicate NIH extramural research support.
The easy way to misread this
Do not conclude that technology-based programs reliably improve chronic illness self-management, mood, or caregiver burden. Many included studies were pilots or quasi-experimental with high or unclear bias, and caregiver and interpersonal outcomes were mixed.