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支持多重疾病自我管理的数字应用:一项范围综述。

Digital applications to support self-management of multimorbidity: A scoping review.

作者信息

Smith Lucy, Simpson Glenn, Holt Sian, Dambha-Miller Hajira

机构信息

Primary Care Research Centre, University of Southampton, Southampton, UK.

Primary Care Research Centre, University of Southampton, Southampton, UK.

出版信息

Int J Med Inform. 2025 Oct;202:105988. doi: 10.1016/j.ijmedinf.2025.105988. Epub 2025 May 20.

Abstract

INTRODUCTION

Multimorbidity, defined as the co-occurrence of two or more long-term conditions, is increasing rapidly and poses challenges for healthcare systems. Advances in digital technologies offer solutions by facilitating personalised, scalable care interventions that empower individuals to manage their conditions more effectively. These applications have potential to improve access to care, enhance patient engagement, and support tailored approaches to self-management.

OBJECTIVES

This scoping review aims to synthesise current evidence on the use of digital applications for self-management in adults with multimorbidity.

METHODS

A scoping review was conducted, systematically searching PubMed, Web of Science, OVID, CINAHL, EMBASE, and additional manual searches. Boolean operators and targeted key terms were employed to retrieve relevant studies from database inception to 16th January 2024.

RESULTS

The search yielded 1,974 articles, of which 31 met the inclusion criteria. Digital applications for self-management in multimorbidity demonstrated high acceptability and varying efficacy. Key benefits included improved communication, symptom tracking, and autonomy. Barriers included privacy concerns, additional patient burden, and engagement challenges. Socio-demographics, self-efficacy, and digital literacy influenced both barriers and facilitators to tool usage. Theoretical models underpinning digital applications were limited. Older adults and the working-age population were rarely included.

CONCLUSION

The current evidence base does not fully address the needs of older adults with low digital literacy or working-age populations with multimorbidity. Our model highlights the importance of broader contextual mechanisms in digital tool adoption. Future research should prioritise theory-driven tool development tailored to disease clusters and aligned with sociodemographic profiles, health risks, and social care needs. Addressing these gaps could improve self-management and health outcomes for high-risk populations.

摘要

引言

多重疾病,定义为两种或更多种长期病症的同时出现,正在迅速增加,并给医疗保健系统带来挑战。数字技术的进步提供了解决方案,通过促进个性化、可扩展的护理干预措施,使个人能够更有效地管理自己的病情。这些应用程序有潜力改善医疗服务的可及性,增强患者参与度,并支持个性化的自我管理方法。

目的

本范围综述旨在综合当前关于数字应用程序在患有多重疾病的成年人自我管理中的使用证据。

方法

进行了一项范围综述,系统地检索了PubMed、科学网、OVID、CINAHL、EMBASE,并进行了额外的手动检索。使用布尔运算符和针对性关键词从数据库建立至2024年1月16日检索相关研究。

结果

检索得到1974篇文章,其中31篇符合纳入标准。用于多重疾病自我管理的数字应用程序显示出较高的可接受性和不同的疗效。主要益处包括改善沟通、症状跟踪和自主性。障碍包括隐私担忧、额外的患者负担和参与挑战。社会人口统计学、自我效能和数字素养影响了工具使用的障碍和促进因素。支撑数字应用程序的理论模型有限。老年人和工作年龄人群很少被纳入。

结论

当前的证据基础并未充分满足数字素养较低的老年人或患有多重疾病的工作年龄人群的需求。我们的模型强调了更广泛的背景机制在数字工具采用中的重要性。未来的研究应优先考虑针对疾病集群并与社会人口统计学特征、健康风险和社会护理需求相一致的理论驱动的工具开发。解决这些差距可以改善高危人群的自我管理和健康结果。

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