Article Text
Abstract
Background A new dimension to healthcare teams’ role is ensuring patient uptake and engagement with digital health interventions (DHIs), a recognised problem in the digital health sphere. DHIs can assist health services by increasing efficiency, reducing cost, and improving individual and population health if patients utilise DHIs effectively. Hence, this review explores the ways healthcare teams facilitate patient uptake and engagement with DHI and assesses the impact the different ways have on patient uptake and engagement with DHIs.
Methods A mixed-method systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An electronic search was performed using the following databases: Embase, Medline, PsychINFO, CINAHLplus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) plus and the Cochrane Central Register of Controlled trials for studies published from January 2000 to June 2022. Supplementary web searches and citation searching were conducted. The population included patients with chronic physical or mental illness using a DHI with assistance from a healthcare team member. Outcomes included qualitative data on the experiences of patients and the healthcare team’s utilisation of a DHI and quantitative data on uptake and engagement rates. Studies were screened and managed using the Endnote software. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). The findings of these studies were narratively synthesised.
Results A total of 5232 studies were identified via databases, citations and hand searching. 274 records were assessed for eligibility, of which only 22 studies were included in the review. Analyses were conducted in the US (n =5), Netherlands (n =4), Sweden (n=2), Australia (n=3), UK (n=3), Canada (n=1), Germany (n=1), Switzerland (n=1), Lithuania (n=1) and Nigeria (n= 1). The most common ways of healthcare team involvement with patient uptake and engagement with DHIs were support, monitoring and reviewing patient progress. Key findings reveal that future DHIs should focus on types of healthcare team members, ways of communication between healthcare teams and patients (frequency, mode of contact and flexibility), and healthcare team support (training, continuity of care and staffing). There was high heterogeneity between the studies quality and evidence.
Discussion The review highlights lessons for healthcare service providers, developers, and healthcare teams to implement while delivering DHIs to patients with chronic illnesses. It also identifies potential health service research surrounding healthcare teams’ delivery of DHIs to patients with chronic illnesses.