eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review

Introduction: Self-management is important in asthma control. Self-management in adolescents is complicated by physical and psychological developmental transitions, which may result in undertreated, potentially life-threatening asthma. It is unclear which interventions fit adolescents’ needs and imp...

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Main Authors: Amanda R. van Buul, Marise J. Kasteleyn, Jellianne M. Arends, Ting Shi, Declan P. Kelly, Niels H. Chavannes, Eline Meijer
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2020-01-01
Series:Clinical eHealth
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2588914120300083
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author Amanda R. van Buul
Marise J. Kasteleyn
Jellianne M. Arends
Ting Shi
Declan P. Kelly
Niels H. Chavannes
Eline Meijer
author_facet Amanda R. van Buul
Marise J. Kasteleyn
Jellianne M. Arends
Ting Shi
Declan P. Kelly
Niels H. Chavannes
Eline Meijer
author_sort Amanda R. van Buul
collection DOAJ
description Introduction: Self-management is important in asthma control. Self-management in adolescents is complicated by physical and psychological developmental transitions, which may result in undertreated, potentially life-threatening asthma. It is unclear which interventions fit adolescents’ needs and improve asthma-related outcomes. This systematic review therefore aimed to identify eHealth interventions that effectively support self-management skills in adolescents with asthma and evaluate the underlying psychological theory. Methods: PubMed, Embase, Web of Science, Cochrane Library and PsycINFO were used. Quality of articles was assessed with validated checklists (i.e., STROBE and CONSORT). eHealth only and blended self-management interventions were reported, including underlying psychological theory (if any), features, usability and effects on outcomes (i.e., self-management, knowledge, self-efficacy, asthma control, quality of life, pulmonary function, medication adherence and healthcare visits). Adolescents’ opinions about eHealth and needs for features were reviewed. Results: 25 empirical (quantitative and qualitative) articles were included, representing nineteen eHealth interventions of which four were blended (i.e. combining eHealth and face-to-face contact) and seven were theory-based. Adolescents found the applications and websites easy to use and were positive about eHealth. The studies showed positive effects of the interventions or no differences on self-management, knowledge, self-efficacy, asthma control, quality of life, pulmonary function, medication adherence and healthcare visits. No publications were found that showed negative results of eHealth programmes. Adolescents were positive about self-monitoring, reminder functions and the possibility to share information with others. Adolescents’ needs for future applications included asthma education, gamification and customisation. Given unclarity about operationalizations of underlying theories and small sample sized in blended care interventions, respectively, this review could not assess whether a theoretical basis or blended mode of delivery was related to effectiveness. Conclusion: eHealth interventions seem safe and outcomes are promising, with several studies showing positive effects on asthma control, quality of life and medication adherence, no adverse outcomes were reported. Results suggest that eHealth interventions may be further improved by increasingly tailoring them to adolescents’ needs, such as self-monitoring, reminder functions and the possibility to share information with others. Therefore, physicians can consider using eHealth in daily practice in this patient group, as stand-alone intervention or as blended care.
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spelling doaj.art-ecc40dbfb48f42f0a05af165ce2ae8872022-12-21T22:02:37ZengKeAi Communications Co., Ltd.Clinical eHealth2588-91412020-01-0134962eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic reviewAmanda R. van Buul0Marise J. Kasteleyn1Jellianne M. Arends2Ting Shi3Declan P. Kelly4Niels H. Chavannes5Eline Meijer6Leiden University Medical Center, Department of Pulmonology, Leiden, The NetherlandsLeiden University Medical Center, Department of Pulmonology, Leiden, The Netherlands; Leiden University Medical Center, Public Health and Primary Care, Leiden, The Netherlands; National eHealth Living Lab (NeLL), Leiden, The NetherlandsReinier de Graaf Gasthuis, Department of Internal Medicine, Delft, The NetherlandsUniversity of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, United KingdomPhilips Research China, Shanghai, People’s Republic of ChinaLeiden University Medical Center, Public Health and Primary Care, Leiden, The Netherlands; National eHealth Living Lab (NeLL), Leiden, The NetherlandsLeiden University Medical Center, Public Health and Primary Care, Leiden, The Netherlands; National eHealth Living Lab (NeLL), Leiden, The Netherlands; Corresponding author at: Leiden University Medical Center, Department of Public Health and Primary Care, Postbox 9600 zone V-0-P, 2300 RC Leiden, The Netherlands.Introduction: Self-management is important in asthma control. Self-management in adolescents is complicated by physical and psychological developmental transitions, which may result in undertreated, potentially life-threatening asthma. It is unclear which interventions fit adolescents’ needs and improve asthma-related outcomes. This systematic review therefore aimed to identify eHealth interventions that effectively support self-management skills in adolescents with asthma and evaluate the underlying psychological theory. Methods: PubMed, Embase, Web of Science, Cochrane Library and PsycINFO were used. Quality of articles was assessed with validated checklists (i.e., STROBE and CONSORT). eHealth only and blended self-management interventions were reported, including underlying psychological theory (if any), features, usability and effects on outcomes (i.e., self-management, knowledge, self-efficacy, asthma control, quality of life, pulmonary function, medication adherence and healthcare visits). Adolescents’ opinions about eHealth and needs for features were reviewed. Results: 25 empirical (quantitative and qualitative) articles were included, representing nineteen eHealth interventions of which four were blended (i.e. combining eHealth and face-to-face contact) and seven were theory-based. Adolescents found the applications and websites easy to use and were positive about eHealth. The studies showed positive effects of the interventions or no differences on self-management, knowledge, self-efficacy, asthma control, quality of life, pulmonary function, medication adherence and healthcare visits. No publications were found that showed negative results of eHealth programmes. Adolescents were positive about self-monitoring, reminder functions and the possibility to share information with others. Adolescents’ needs for future applications included asthma education, gamification and customisation. Given unclarity about operationalizations of underlying theories and small sample sized in blended care interventions, respectively, this review could not assess whether a theoretical basis or blended mode of delivery was related to effectiveness. Conclusion: eHealth interventions seem safe and outcomes are promising, with several studies showing positive effects on asthma control, quality of life and medication adherence, no adverse outcomes were reported. Results suggest that eHealth interventions may be further improved by increasingly tailoring them to adolescents’ needs, such as self-monitoring, reminder functions and the possibility to share information with others. Therefore, physicians can consider using eHealth in daily practice in this patient group, as stand-alone intervention or as blended care.http://www.sciencedirect.com/science/article/pii/S2588914120300083AsthmaAdolescentseHealthSelf-managementUser experience
spellingShingle Amanda R. van Buul
Marise J. Kasteleyn
Jellianne M. Arends
Ting Shi
Declan P. Kelly
Niels H. Chavannes
Eline Meijer
eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
Clinical eHealth
Asthma
Adolescents
eHealth
Self-management
User experience
title eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
title_full eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
title_fullStr eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
title_full_unstemmed eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
title_short eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review
title_sort ehealth only interventions and blended interventions to support self management in adolescents with asthma a systematic review
topic Asthma
Adolescents
eHealth
Self-management
User experience
url http://www.sciencedirect.com/science/article/pii/S2588914120300083
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