School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China.
Int J Med Inform. 2022 Apr;160:104709. doi: 10.1016/j.ijmedinf.2022.104709. Epub 2022 Feb 5.
Digital health interventions can potentially improve the integration of the health care systems. Hip fracture is a serious injury for older people and integrated post-surgery care is vital for good recovery.
We aimed to characterise digital health interventions used for hip fracture post-surgery care, and further to examine the extent to which of these interventions address the World Health Organisation (WHO) integrated care for older people (ICOPE) framework.
A scoping review was conducted, by searching the literature from English and Chinese databases and trial registries. Keywords included hip fracture, post-surgery care and digital health interventions. Interventional, observational, qualitative studies and case reports were included. We used a combined framework, WHO ICOPE and WHO digital health intervention classifications, to support data synthesis.
A total of 4,542 articles were identified, of which 39 studies were included in the analysis. We identified only six randomised controlled trials. Digital health interventions were mainly used to help doctors provide clinical care and facilitate service delivery between the patients and healthcare providers. No studies focused on health workforce, financial policy or the development of infrastructure. The primary users were healthcare providers and patients, without healthcare managers or the use of data services. Most digital health interventions focused on physical therapy, bone protection and falls prevention. Limited interventions were implemented in low-and middle-income countries.
A stronger evidence base is needed to expand the use of digital health for post-surgery care of hip fracture patients, including high-quality larger-scale studies, more focus in resource-constrained settings, expanding to more users and capabilities of interventions, and exploring the role of digital health for the integrated care model to mitigate health system challenges.
数字健康干预措施有可能改善医疗保健系统的整合。髋部骨折是老年人的严重伤害,术后综合护理对于良好康复至关重要。
我们旨在描述用于髋部骨折术后护理的数字健康干预措施,并进一步研究这些干预措施在多大程度上符合世界卫生组织(WHO)老年人综合护理(ICOPE)框架。
通过搜索英文和中文数据库以及试验注册处的文献进行了范围审查。关键词包括髋部骨折、术后护理和数字健康干预措施。纳入了干预性、观察性、定性研究和病例报告。我们使用 WHO ICOPE 和 WHO 数字健康干预分类的组合框架来支持数据综合。
共确定了 4542 篇文章,其中 39 项研究纳入了分析。我们只确定了 6 项随机对照试验。数字健康干预措施主要用于帮助医生提供临床护理,并促进患者与医疗保健提供者之间的服务提供。没有研究关注卫生人力、财务政策或基础设施的发展。主要使用者是医疗保健提供者和患者,没有医疗保健管理人员或数据服务的使用。大多数数字健康干预措施侧重于物理治疗、骨保护和预防跌倒。在中低收入国家实施的干预措施有限。
需要更多高质量的大规模研究来扩大数字健康在髋部骨折患者术后护理中的应用,包括在资源有限的环境中更加关注、扩大干预措施的使用范围和功能,并探索数字健康在综合护理模式中的作用,以缓解卫生系统的挑战。