The efficacy of technology designed to support older adults’ chronic disease self-management: A systematic review. (Preprint)

BACKGROUND Amid the proliferation of health information technology (HIT) designed to support patients in following recommended chronic disease self-management behaviors (i.e., medication behavior, physical activity, dietary behavior and attending follow-up appointments), health inequities persist among older adults for chronic disease outcomes. Numerous interventions that use consumer-oriented HIT to support self-management have been evaluated, and some of the related literature has focused on older adults who experience disparate chronic disease outcomes. However, little is known about the efficacy of these interventions. OBJECTIVE This study aims to conduct a systematic review of the literature that describes the efficacy of consumer-oriented HIT interventions designed to support self-management involving older adults. METHODS We followed an a priori protocol using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity 2020 Extension guidelines for systematic reviews that focus on health equity. Themes of interest included the inclusion and exclusion criteria. We identified seven electronic databases, created search strings, and conducted the searches. We initially screened results based on titles and abstracts and then performed full-text screening. We then resolved conflicts and extracted relevant data from the included articles. RESULTS In total, there were seven included articles. All studies included older adult patients, which we define as 65 or older. All studies focused on technologies that support chronic disease self-management for older adults, such as medication behavior, and dietary behavior, and physical activity, and attending follow-up appointments. Medical specialties ranged from physical rehabilitation, to computer engineering, to internet research, etc. Study types included non-experimental (5/7, 71%), non-randomized clinical trial (1/7, 11%), and single-blind randomized controlled trial (1/7, 11%). CONCLUSIONS This study addresses a key gap in research that has not sufficiently examined what technology designs and capabilities may be effective in supporting older adults following recommendations for chronic disease self-management.