Usability of eHealth and mHealth interventions on self-management during healthcare transition for adolescents and young adults with chronic illness: A systematic review (Preprint)

BACKGROUND In light of the ability of digital health interventions to improve the accessibility and availability of health education, the development of psychosocial interventions and social support for adolescents and young adults (AYAs), and increasing ownership rates of digital technology among AYAs, innovative methods should be considered to improve the current care model and enhance the self-management skills of AYAs with chronic disease during the healthcare transition process. OBJECTIVE This systematic review aimed to describe the features of eHealth and mobile health (mHealth) interventions and to evaluate their usability with regard to supporting AYAs with chronic disease during their transition from paediatric to adult healthcare services. METHODS This review followed the PRISMA guidelines. We systematically searched the MEDLINE complete, EMBASE, Cochrane Library, CINAHL complete, and ProQuest databases. We considered only articles published in or since 2019, as we aimed to extend the data collected by 2 previous systematic reviews. Two authors independently appraised the comprehensiveness of each research report. RESULTS A total of 16752 studies were screened, and 22 studies were included. The interventions were summarized into 6 themes: medication monitoring and reminders, symptom tracking and monitoring, management goal setting, knowledge education and self-management skills training, incentives and reinforcement, and communication. These interventions ranged from simple text messages to more complex interventions involving interactive games and engagement on the part of healthcare providers. Most interventions (20/22) involved mobile apps, with only two interventions (2/22) taking the form of websites or text messaging. Engagement was promoted through behavioural changes or incentive measures as well as designs and functions that were in line with patient preferences; furthermore, barriers to adherence were overcome through personal reminders, monitoring, and flexible programme schedules. Most AYAs felt that the interventions delivered by mobile apps or websites were feasible, as they were convenient, easy to use, and accessible in the context of helping AYAs manage their health. CONCLUSIONS Due to the lack of rigorous testing and heterogeneity, which limits the detailed description of the data synthesized as part of this review, it is necessary to carefully consider the results of this review. Based on the available evidence, eHealth and mHealth interventions may be feasible and applicable; however, additional studies based on these theories that can take into account input from patients and healthcare professionals at all stages are needed to determine the effectiveness of such interventions. CLINICALTRIAL The protocol for this systematic review was registered on PROSPERO (registration number CRD42023378355)