Sun Chao, Dai Huohuo, M J J van der Kleij Rianne, Li Rong, Wu Hengchang, Hallensleben Cynthia, Willems Sofie H, Chavannes Niels H
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
National eHealth Living Lab, Leiden, The Netherlands.
J Med Internet Res. 2025 Mar 18;27:e53142. doi: 10.2196/53142.
Chronic lung disease (CLD) is one of the most prevalent noncommunicable diseases globally, significantly burdening patients and increasing health care expenditures. Digital health education (DHE) is increasingly important in chronic disease prevention and management. However, DHE characteristics and impacts in CLD are rarely reported.
This study aimed to provide an overview of the existing literature on DHE for CLD, with a focus on exploring the DHE mediums, content, mechanisms, and reported outcomes in patients with CLD.
We searched PubMed, Web of Science, Embase, PsycINFO, and The Cochrane Library with the assistance of a librarian specialist. Articles were screened by the reviewer team with ASReview (Utrecht University) and EndNote X9 (Clarivate Analytics) based on predefined inclusion and exclusion criteria and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Quality assessment was conducted with the Critical Appraisal Skills Program tool. A descriptive analysis was used to summarize the study characteristics, DHE characteristics, and outcomes.
A total of 22 studies were included in this review with medium or high quality. They were published between 2000 and 2022, showing an increasing publication trend with the year, mostly in developed countries (16/22, 73%). Websites and mobile apps (10/22, 45%) were the most widely used DHE medium. Education on self-management skills of CLD was the primary topic (21/22, 95%), 4/22 (18%) of which mentioned DHE mechanisms. The majority of studies reported positive changes in CLD awareness (14/16, 88%), clinical outcomes (3/6, 50%), DHE feasibility, acceptability, and satisfaction (6/8, 75%), lifestyle outcomes (3/3, 100%), and psychosocial outcomes (7/8, 88%). Only 2 studies reported cost-effectiveness (2/22, 9%).
Despite the heterogeneity of the study situation, some aspects can be concluded. DHE can improve disease awareness and clinical outcomes in patients with chronic lung disease, with good feasibility, acceptability, and satisfaction through different mediums and learning content. There is still relatively little research among people in low- and middle-income countries. Future research should consider the impact on cost-effectiveness, duration, frequency, and theoretical mechanisms of the DHE to maximize the potential impact. It should also be conducted in the context of health services research to better reflect the real world.
慢性肺病（CLD）是全球最常见的非传染性疾病之一，给患者带来沉重负担并增加了医疗保健支出。数字健康教育（DHE）在慢性病预防和管理中日益重要。然而，关于CLD中DHE的特征和影响的报道很少。
本研究旨在概述现有关于CLD的DHE文献，重点探索CLD患者的DHE媒介、内容、机制和报告的结果。
我们在一位图书馆专家的协助下检索了PubMed、Web of Science、Embase、PsycINFO和Cochrane图书馆。文章由评审团队使用ASReview（乌得勒支大学）和EndNote X9（科睿唯安）根据预定义的纳入和排除标准以及PRISMA-ScR（系统评价和Meta分析扩展的范围综述的首选报告项目）清单进行筛选。使用批判性评估技能计划工具进行质量评估。采用描述性分析来总结研究特征、DHE特征和结果。
本综述共纳入22项质量中等或较高的研究。它们发表于2000年至2022年之间，并呈现出随年份增加的发表趋势，大部分研究来自发达国家（16/22，73%）。网站和移动应用程序（10/22，45%）是最广泛使用的DHE媒介。CLD自我管理技能教育是主要主题（21/22，95%），其中4/22（18%）提到了DHE机制。大多数研究报告了CLD认知方面的积极变化（14/16，88%）、临床结果（3/6，50%）、DHE的可行性、可接受性和满意度（6/8，75%）、生活方式结果（3/3，100%）以及心理社会结果（7/8，88%）。只有2项研究报告了成本效益（2/22，9%）。
尽管研究情况存在异质性，但仍可得出一些结论。DHE可以提高慢性肺病患者的疾病认知和临床结果，通过不同媒介和学习内容具有良好的可行性、可接受性和满意度。低收入和中等收入国家人群中的研究仍然相对较少。未来的研究应考虑DHE对成本效益、持续时间、频率和理论机制的影响，以最大限度地发挥潜在影响。还应在卫生服务研究的背景下进行，以更好地反映现实世界。
