A systematic review of the literature reporting on studies that examined the impact of interactive, computer-based patient education programs.

OBJECTIVE To evaluate studies that examined the impact of interactive, computer-based education (ICBE) programs on patient education. METHODS The Medline and CINAHL databases were searched to identify randomized controlled studies that evaluated the impact of ICBE programs. RESULTS The 25 studies that met the selection criteria generally supported the ability of ICBE programs to promote knowledge gains. Results related to economic or clinical outcomes were less consistent. Significant variations were noted across studies in program features, implementation and integration strategies, and in comparison program attributes and quality. It is likely that these differences contributed to the disparity in findings across studies. CONCLUSION Although significant inconsistencies in results were noted, the research provided collective evidence that ICBE programs had the potential to add great value to the patient education process. Programs must be properly designed and implementation and integration processes effectively planned in order to achieve consistently positive outcomes. PRACTICE IMPLICATIONS Consideration of the "best practices" derived from the research and noted in this report will assist healthcare providers in designing, selecting, and implementing effective ICBE programs.

[1]  P. Naumann,et al.  Computer game for inner-city children does not improve asthma outcomes. , 2003, Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners.

[2]  Peter Tugwell,et al.  A randomized trial of a computerized versus an audio-booklet decision aid for women considering post-menopausal hormone replacement therapy. , 2002, Patient education and counseling.

[3]  L. K. Bartholomew,et al.  Watch, Discover, Think, and Act: evaluation of computer-assisted instruction to improve asthma self-management in inner-city children. , 2000, Patient education and counseling.

[4]  T. Beebe,et al.  A Randomized, Controlled Trial of Interactive, Multimedia Software for Patient Colonoscopy Education , 2001, Journal of clinical gastroenterology.

[5]  J. Reis,et al.  Computerized Training in Breast Self‐examination: A Test in a Community Health Center , 2004, Cancer nursing.

[6]  Zoe Strickler,et al.  An interactive technology approach to educate older adults about drug interactions arising from over-the-counter self-medication practices. , 2002, Public health nursing.

[7]  J M Atkinson,et al.  Randomised trial of personalised computer based information for patients with schizophrenia , 2001, BMJ : British Medical Journal.

[8]  M. H. Hill,et al.  Relationships among patient satisfaction, intent to return, and intent to recommend services provided by an academic nursing center. , 2002, Journal of cultural diversity.

[9]  T. Brennan,et al.  Intention to discontinue care among primary care patients , 2001, Journal of General Internal Medicine.

[10]  L. Schneider,et al.  An evaluation of an innovative multimedia educational software program for asthma management: report of a randomized, controlled trial. , 2000, Pediatrics.

[11]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[12]  A. Evans,et al.  Computer-assisted instruction: an effective instructional method for HIV prevention education? , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[13]  Mark C K Yang,et al.  Controlled evaluation of the STARBRIGHT CD-ROM program for children and adolescents with Cystic Fibrosis. , 2004, Journal of pediatric psychology.

[14]  T. R. Taylor,et al.  A tale of two studies: the importance of setting, subjects and context in two randomized, controlled trials of a web-based decision support for perimenopausal and postmenopausal health decisions. , 2007, Patient education and counseling.

[15]  M. Boccia,et al.  The effect of format modifications and reading comprehension on recall of informed consent information by low-income parents: a comparison of print, video, and computer-based presentations. , 2004, Patient education and counseling.

[16]  D. Lewis,et al.  Computers in Patient Education , 2003, Computers, informatics, nursing : CIN.

[17]  W. Bickel,et al.  Efficacy of computer-based HIV/AIDS education for injection drug users. , 2004, American journal of health behavior.

[18]  M. Hoffman,et al.  NPs vs. IT for effective colposcopy patient education. , 2005 .

[19]  B. Keulers,et al.  Can face-to-face patient education be replaced by computer-based patient education? A randomised trial. , 2007 .

[20]  L. Case,et al.  Using a computer to teach patients about fecal occult blood screening , 2005, Journal of General Internal Medicine.

[21]  J. Habbema,et al.  Effects of an individualized multimedia computer program for health education in patients with a recent minor stroke or transient ischemic attack – a randomized controlled trial , 2007, Acta neurologica Scandinavica.

[22]  R. Paschke,et al.  Comparative analysis of conventional training and a computer-based interactive training program for celiac disease patients. , 2004, Patient education and counseling.

[23]  Santosh Krishna,et al.  Internet-enabled interactive multimedia asthma education program: a randomized trial. , 2003, Pediatrics.

[24]  Woo-Hyun Cho,et al.  The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study , 2004 .

[25]  John P. Mullooly,et al.  Physician-Patient Communication: The Relationship With Malpractice Claims Among Primary Care Physicians and Surgeons , 1997 .

[26]  H. Liedholm,et al.  Effects of an interactive CD-program on 6 months readmission rate in patients with heart failure – a randomised, controlled trial [NCT00311194] , 2006, BMC Cardiovascular Disorders.

[27]  Andrew N Garman,et al.  Patient Satisfaction as a Predictor of Return‐to‐Provider Behavior: Analysis and Assessment of Financial Implications , 2004, Quality management in health care.

[28]  Michael L Berbaum,et al.  Implementation and evaluation of a low-literacy diabetes education computer multimedia application. , 2005, Diabetes care.

[29]  Edward D. Smith,et al.  The multimedia computer for office-based patient education: a systematic review. , 2005, Patient education and counseling.

[30]  J. Donovan,et al.  A randomized trial comparing the effectiveness and preference of a touch‐screen computer system with a leaflet for providing women with information on urinary symptoms suggestive of detrusor instability , 2001, BJU international.

[31]  Anna Strömberg,et al.  Computer-based education for patients with chronic heart failure. A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. , 2006, Patient education and counseling.

[32]  E John Orav,et al.  The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. , 2005, The American journal of medicine.

[33]  Michael J Green,et al.  Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: a randomized controlled trial. , 2004, JAMA.

[34]  Deborah Lewis,et al.  Review: Computer-based Approaches to Patient Education: A Review of the Literature , 1999, J. Am. Medical Informatics Assoc..

[35]  Ng Yuen Yee Jenny,et al.  Evaluating the Effectiveness of an Interactive Multimedia Computer-Based Patient Education Program in Cardiac Rehabilitation , 2001 .