A scoping review of digital health technologies in multimorbidity management: mechanisms, outcomes, challenges, and strategies.

Abstract

Introduction: Multimorbidity amplifies healthcare burdens due to the intricate requirements of patients and the pathophysiological complexities of multiple diseases. To address this, digital health technologies play a crucial role in effective healthcare delivery, requiring comprehensive evidence on their applications in managing multimorbidity. Therefore, this scoping review aims to identify various types of digital health technologies, explore their mechanisms, and identify barriers and facilitators within the context of multimorbidity.

Methods: This scoping review follows the Preferred Reporting Items for Scoping Reviews guidelines. PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were used to search articles. Data extraction focused on study characteristics, types of health technologies, mechanisms, outcomes, challenges, and facilitators. Results were presented using figures, tables, and texts. Thematic analysis was employed to describe mechanisms, impacts, challenges, and strategies related to digital health technologies in managing multimorbidity.

Results: Digital health technology encompasses smartphone apps, wearable devices, and platforms for remote healthcare (telehealth). These technologies work through care coordination, collaboration, communication, self-management, remote monitoring, health data management, and tele-referrals. Digital health technologies improved quality of care and life, cost efficiency, acceptability of care, collaboration, streamlined healthcare delivery, reduced workload, and bridging knowledge gaps. Patients' and healthcare providers' resistance and skills, lack of support (technical, financial, and infrastructure), and ethical concerns (e.g., privacy) barred digital health technologies implementation. Arranging organization, providing technical support, employing care coordination strategies, enhancing acceptability, deploying appropriate technology, considering patient needs, and adhering with ethical principles facilitate digital health technologies implementation.

Conclusions: Digital health technology holds significant promise in improving care for individuals with multimorbidity by enhancing coordination, self-management, and monitoring. Successful implementation requires addressing challenges such as patient resistance and infrastructure limitations through targeted strategies and investments. It is also essential to consider usability, privacy, and trustworthiness when adopting these tools.