Finucane Anne M, O'Donnell Hannah, Lugton Jean, Gibson-Watt Tilly, Swenson Connie, Pagliari Claudia
Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK.
Marie Curie Hospice Edinburgh, Edinburgh, Scotland, UK.
NPJ Digit Med. 2021 Apr 6;4(1):64. doi: 10.1038/s41746-021-00430-7.
Digital health interventions (DHIs) have the potential to improve the accessibility and effectiveness of palliative care but heterogeneity amongst existing systematic reviews presents a challenge for evidence synthesis. This meta-review applied a structured search of ten databases from 2006 to 2020, revealing 21 relevant systematic reviews, encompassing 332 publications. Interventions delivered via videoconferencing (17%), electronic healthcare records (16%) and phone (13%) were most frequently described in studies within reviews. DHIs were typically used in palliative care for education (20%), symptom management (15%), decision-making (13%), information provision or management (13%) and communication (9%). Across all reviews, mostly positive impacts were reported on education, information sharing, decision-making, communication and costs. Impacts on quality of life and physical and psychological symptoms were inconclusive. Applying AMSTAR 2 criteria, most reviews were judged as low quality as they lacked a protocol or did not consider risk of bias, so findings need to be interpreted with caution.
数字健康干预措施(DHIs)有潜力提高姑息治疗的可及性和有效性,但现有系统评价之间的异质性给证据综合带来了挑战。这项元评价对2006年至2020年的十个数据库进行了结构化检索,共检索到21篇相关系统评价,涵盖332篇出版物。在系统评价中的研究中,通过视频会议(17%)、电子健康记录(16%)和电话(13%)实施的干预措施被描述得最为频繁。数字健康干预措施在姑息治疗中通常用于教育(20%)、症状管理(15%)、决策(13%)、信息提供或管理(13%)以及沟通(9%)。在所有系统评价中,报告的教育、信息共享、决策、沟通和成本方面大多具有积极影响。对生活质量以及身体和心理症状的影响尚无定论。根据AMSTAR 2标准,大多数系统评价被判定为低质量,因为它们缺乏方案或未考虑偏倚风险,因此研究结果需要谨慎解读。