Information technology to support self-management in chronic care: A systematic review
Systematic literature review
Informed individuals who are actively engaged in managing the daily challenges of their chronic disease are the change agents in a health care system, which is presently unresponsive to the needs of this growing population. The application of information technology (IT) to support self-management extends the reach of the provider organization by linking patients to the exchange of health information and facilitating self-management activities. This systematic review of the literature was conducted to illuminate the application of IT enabling consumer self-management and health care provider support of self-management. Selected articles were analyzed to determine the self-management functions supported by IT and to synthesize findings on tools’ efficacy in terms of improving self-management performance and health outcomes. An additional perspective of this review is an exploration of the extent to which research in self-management technologies is being conducted to support the chronic care model (CCM) conceived by Wagner and colleagues. Self-management and information technology are essential elements of the CCM. Conceptual models of health care systems where individual-centered care or coordination of care are central themes served as an analytical framework for the review.
Results indicate that most research is focused on the use of IT by individuals for self-education and self-monitoring, with a small number of studies exploring applications to enable collaboration of providers and individuals in self-management planning and activities. Changes in patient adherence and levels of knowledge were the most popular outcome variables measured, with reports of significant improvements in both areas. However, limitations in study designs suggest that the effect of IT-based self-management tools on patient adherence and clinical outcomes is inconclusive. This systematic review affirms the importance of extending the IT infrastructure of the health care system to support the self-management activities of individuals striving to control their chronic disease.
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