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多病症管理中数字健康技术的范围综述:机制、结果、挑战与策略

A scoping review of digital health technologies in multimorbidity management: mechanisms, outcomes, challenges, and strategies.

作者信息

Endalamaw Aklilu, Zewdie Anteneh, Wolka Eskinder, Assefa Yibeltal

机构信息

School of Public Health, The University of Queensland, Brisbane, Australia.

College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

BMC Health Serv Res. 2025 Mar 15;25(1):382. doi: 10.1186/s12913-025-12548-5.

Abstract

INTRODUCTION

Multimorbidity amplifies healthcare burdens due to the intricate requirements of patients and the pathophysiological complexities of multiple diseases. To address this, digital health technologies play a crucial role in effective healthcare delivery, requiring comprehensive evidence on their applications in managing multimorbidity. Therefore, this scoping review aims to identify various types of digital health technologies, explore their mechanisms, and identify barriers and facilitators within the context of multimorbidity.

METHODS

This scoping review follows the Preferred Reporting Items for Scoping Reviews guidelines. PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were used to search articles. Data extraction focused on study characteristics, types of health technologies, mechanisms, outcomes, challenges, and facilitators. Results were presented using figures, tables, and texts. Thematic analysis was employed to describe mechanisms, impacts, challenges, and strategies related to digital health technologies in managing multimorbidity.

RESULTS

Digital health technology encompasses smartphone apps, wearable devices, and platforms for remote healthcare (telehealth). These technologies work through care coordination, collaboration, communication, self-management, remote monitoring, health data management, and tele-referrals. Digital health technologies improved quality of care and life, cost efficiency, acceptability of care, collaboration, streamlined healthcare delivery, reduced workload, and bridging knowledge gaps. Patients' and healthcare providers' resistance and skills, lack of support (technical, financial, and infrastructure), and ethical concerns (e.g., privacy) barred digital health technologies implementation. Arranging organization, providing technical support, employing care coordination strategies, enhancing acceptability, deploying appropriate technology, considering patient needs, and adhering with ethical principles facilitate digital health technologies implementation.

CONCLUSIONS

Digital health technology holds significant promise in improving care for individuals with multimorbidity by enhancing coordination, self-management, and monitoring. Successful implementation requires addressing challenges such as patient resistance and infrastructure limitations through targeted strategies and investments. It is also essential to consider usability, privacy, and trustworthiness when adopting these tools.

摘要

引言

由于患者的复杂需求和多种疾病的病理生理复杂性,多重疾病加剧了医疗负担。为解决这一问题,数字健康技术在有效的医疗服务提供中发挥着关键作用,这需要关于其在管理多重疾病方面应用的全面证据。因此,本综述旨在识别各种类型的数字健康技术,探索其机制,并确定多重疾病背景下的障碍和促进因素。

方法

本综述遵循《范围综述报告的首选项目》指南。使用PubMed、Scopus、Web of Science、EMBASE和谷歌学术搜索文章。数据提取集中在研究特征、健康技术类型、机制、结果、挑战和促进因素。结果通过图表和文本呈现。采用主题分析来描述与数字健康技术在管理多重疾病方面相关的机制、影响、挑战和策略。

结果

数字健康技术包括智能手机应用程序、可穿戴设备和远程医疗平台(远程保健)。这些技术通过护理协调、协作、沟通、自我管理、远程监测、健康数据管理和远程转诊发挥作用。数字健康技术提高了护理质量和生活质量、成本效益、护理可接受性、协作、简化了医疗服务提供、减轻了工作量并弥合了知识差距。患者和医疗服务提供者的抵触情绪和技能、缺乏支持(技术、资金和基础设施)以及伦理问题(如隐私)阻碍了数字健康技术的实施。安排组织、提供技术支持、采用护理协调策略、提高可接受性、部署适当技术、考虑患者需求并遵守伦理原则有助于数字健康技术的实施。

结论

数字健康技术在通过加强协调、自我管理和监测改善对患有多重疾病个体的护理方面具有巨大潜力。成功实施需要通过有针对性的策略和投资应对患者抵触和基础设施限制等挑战。在采用这些工具时,考虑可用性、隐私和可信度也至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4457/11909923/216ad9dfd183/12913_2025_12548_Fig1_HTML.jpg

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