Xiong Shangzhi, Lu Hongsheng, Peoples Nicholas, Duman Ege K, Najarro Alberto, Ni Zhao, Gong Enying, Yin Ruoyu, Ostbye Truls, Palileo-Villanueva Lia M, Doma Rinchen, Kafle Sweta, Tian Maoyi, Yan Lijing L
The George Institute for Global Health, Faulty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Global Health Research Centre, Duke Kunshan University, Kunshan, China.
NPJ Digit Med. 2023 Feb 1;6(1):12. doi: 10.1038/s41746-023-00764-4.
Current evidence on digital health interventions is disproportionately concerned with high-income countries and hospital settings. This scoping review evaluates the extent of use and effectiveness of digital health interventions for non-communicable disease (NCD) management in primary healthcare settings of low- and middle-income countries (LMICs) and identifies factors influencing digital health interventions' uptake. We use PubMed, Embase, and Web of Science search results from January 2010 to 2021. Of 8866 results, 52 met eligibility criteria (31 reviews, 21 trials). Benchmarked against World Health Organization's digital health classifications, only 14 out of 28 digital health intervention categories are found, suggesting critical under-use and lagging innovation. Digital health interventions' effectiveness vary across outcomes: clinical (mixed), behavioral (positively inclined), and service implementation outcomes (clear effectiveness). We further identify multiple factors influencing digital health intervention uptake, including political commitment, interactivity, user-centered design, and integration with existing systems, which points to future research and practices to invigorate digital health interventions for NCD management in primary health care of LMICs.
目前关于数字健康干预措施的证据主要集中在高收入国家和医院环境,对低收入和中等收入国家(LMICs)关注不足。本综述评估了数字健康干预措施在低收入和中等收入国家初级卫生保健机构中用于非传染性疾病(NCD)管理的使用程度和有效性,并确定了影响数字健康干预措施采用的因素。我们使用了2010年1月至2021年期间PubMed、Embase和Web of Science的搜索结果。在8866条结果中,52条符合纳入标准(31篇综述,21项试验)。对照世界卫生组织的数字健康分类标准,在28种数字健康干预类别中仅发现14种,这表明存在严重的使用不足和创新滞后问题。数字健康干预措施的有效性因结果而异:临床结果(好坏参半)、行为结果(呈积极趋势)和服务实施结果(有效性明显)。我们进一步确定了影响数字健康干预措施采用的多个因素,包括政治承诺、交互性、以用户为中心的设计以及与现有系统的整合,这为未来在低收入和中等收入国家初级卫生保健中促进数字健康干预措施用于非传染性疾病管理的研究和实践指明了方向。