The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review

Background In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. Objective The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. Methods A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Results Patients’ knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. Conclusions The effect of asynchronous communication is not shown unequivocally in these studies. Patients seem to be interested in using email. Patients are willing to participate and are taking the initiative to discuss health issues with their providers. Additional testing of the effects of asynchronous communication on self-management in chronically ill patients is needed.

[1]  A. Passmore,et al.  Effectiveness of an online fatigue self-management programme for people with chronic neurological conditions: a randomized controlled trial , 2010, Clinical rehabilitation.

[2]  Clarann Weinert,et al.  Health knowledge acquisition by rural women with chronic health conditions: a tale of two Web approaches. , 2008, The Australian journal of rural health.

[3]  M. Rijken,et al.  Available Support and Received Support: Different Effects Under Stressful Circumstances , 1997 .

[4]  K. Lorig,et al.  Hispanic Chronic Disease Self-Management: A Randomized Community-Based Outcome Trial , 2003, Nursing research.

[5]  G. Eysenbach.  The Law of Attrition , 2005, Journal of medical Internet research.

[6]  B. Comstock,et al.  Computer Intervention Impact on Psychosocial Adaptation of Rural Women With Chronic Conditions , 2011, Nursing research.

[7]  K. Lorig,et al.  Can a Back Pain E-mail Discussion Group improve health status and lower health care costs?: A randomized study. , 2002, Archives of internal medicine.

[8]  Richard Baker,et al.  Older people's preferences for involvement in their own care: a qualitative study in primary health care in 11 European countries. , 2007, Patient education and counseling.

[9]  Marita Koivunen,et al.  Patients' perceptions of Internet usage and their opportunity to obtain health information , 2007, Medical informatics and the Internet in medicine.

[10]  Tsipi Heart,et al.  Older adults: Are they ready to adopt health-related ICT? , 2013, Int. J. Medical Informatics.

[11]  Kavita Radhakrishnan,et al.  Impact of Telehealth on Patient Self-management of Heart Failure: A Review of Literature , 2012, The Journal of cardiovascular nursing.

[12]  D. Wantland,et al.  The Effectiveness of Web-Based vs. Non-Web-Based Interventions: A Meta-Analysis of Behavioral Change Outcomes , 2004, Journal of medical Internet research.

[13]  Betty A Levine,et al.  Web-based care management in patients with poorly controlled diabetes. , 2005, Diabetes care.

[14]  Chen-Tan Lin,et al.  An Internet-Based Patient-Provider Communication System: Randomized Controlled Trial , 2005, Journal of medical Internet research.

[15]  S. Michie,et al.  Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis, Use of Behavior Change Techniques, and Mode of Delivery on Efficacy , 2010, Journal of medical Internet research.

[16]  Laurie A. Moore,et al.  Providing a Web-based Online Medical Record with Electronic Communication Capabilities to Patients With Congestive Heart Failure: Randomized Trial , 2004, Journal of medical Internet research.

[17]  Bonnie J Wakefield,et al.  Internet use by primary care patients: where is the digital divide? , 2012, Family medicine.

[18]  Seth Wolpin,et al.  Internet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease. , 2013, Journal of pain and symptom management.

[19]  N. Oudshoorn.  Diagnosis at a distance: the invisible work of patients and healthcare professionals in cardiac telemonitoring technology. , 2008, Sociology of health & illness.

[20]  Clarann Weinert,et al.  Influence of a Computer Intervention on the Psychological Status of Chronically Ill Rural Women: Preliminary Results , 2006, Nursing research.

[21]  Michael Weiner,et al.  Using Information Technology To Improve the Health Care of Older Adults , 2003, Annals of Internal Medicine.

[22]  J. Cleland,et al.  Which components of heart failure programmes are effective? A systematic review and meta‐analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review , 2011, European journal of heart failure.

[23]  Elizabeth Murray,et al.  Interactive Health Communication Applications for people with chronic disease. , 2005, The Cochrane database of systematic reviews.

[24]  Hee-Seung Kim,et al.  Establishment of blood glucose monitoring system using the internet. , 2003, Diabetes care.

[25]  Elske Ammenwerth,et al.  The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials , 2012, Journal of medical Internet research.

[26]  J. Knottnerus,et al.  How should we define health? , 2011, BMJ : British Medical Journal.

[27]  R. Osborne,et al.  Protocol for a randomised controlled trial of chronic disease self-management support for older Australians with multiple chronic diseases. , 2011, Contemporary clinical trials.

[28]  Rita Bode,et al.  The effectiveness of an online mind-body intervention for older adults with chronic pain. , 2009, The journal of pain : official journal of the American Pain Society.

[29]  Peter J Sterk,et al.  Internet-Based Self-management Plus Education Compared With Usual Care in Asthma , 2009, Annals of Internal Medicine.

[30]  Susan M McCurry,et al.  The effects of a web-based intervention on the physical outcomes associated with diabetes among adults age 60 and older: a randomized trial. , 2007, Diabetes technology & therapeutics.

[31]  Beth Chaney,et al.  Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review , 2013, Journal of medical Internet research.

[32]  H. van Os-Medendorp,et al.  A systematic review of the effects of e-health on chronically ill patients. , 2011, Journal of clinical nursing.

[33]  M. Stewart,et al.  Effect on Health-Related Outcomes of Interventions to Alter the Interaction Between Patients and Practitioners: A Systematic Review of Trials , 2004, The Annals of Family Medicine.

[34]  F. Schellevis,et al.  NIVEL Overzichtstudies: zorg voor chronisch zieken: organisatie van zorg, zelfmanagement, zelfredzaamheid en participatie. , 2011 .

[35]  Paul A. Fontelo,et al.  Utilization of the PICO framework to improve searching PubMed for clinical questions , 2007, BMC Medical Informatics Decis. Mak..

[36]  Altamiro Costa-Pereira,et al.  Web-based or paper-based self-management tools for asthma--patients' opinions and quality of data in a randomized crossover study. , 2007, Studies in health technology and informatics.

[37]  Jeffrey Soar,et al.  Barriers to use of information and computer technology by Australia's nurses: a national survey. , 2009, Journal of Clinical Nursing.

[38]  Suzanne G. Leveille,et al.  Improving Patient-Clinician Communication About Chronic Conditions: Description of an Internet-Based Nurse E-Coach Intervention , 2008, Nursing research.

[39]  James D. Ralston,et al.  Web-Based Collaborative Care for Type 2 Diabetes , 2009, Diabetes Care.

[40]  Glyn Elwyn,et al.  Patient-based outcome results from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice. , 2004, Family practice.

[41]  C. Anandan,et al.  The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview , 2011, PLoS medicine.