Evidence map›Paper›PMID 40176012›Full record

SynthesisBMC health services research2025

A realist review of factors critical for the implementation of eHealth in chronic disease management.

Nida Shahid, Gillian Parker, Joanna M Bielecki, Valeria Rac, Whitney Berta

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nida ShahidInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. nida.shahid@mail.utoronto.ca.
Gillian ParkerInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Joanna M BieleckiProgram for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Valeria RacInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Whitney BertaInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Canada, chronic disease is responsible for 88% of deaths and $120 billion in cost each year. With 44% of Canadian adults living with at least one chronic condition, only 66% receive necessary care. Ehealth interventions are instrumental in chronic disease management (CDM), especially since the pandemic, as they provide accessible, cost-effective solutions for self-management. Despite its promise and accelerated use, its implementation remains challenging. This paper reports on a realist review of critical factors for the implementation of eHealth interventions relevant to conditions such as heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes. The findings are presented in terms of context, mechanisms, and outcomes.

methodsA realist review of the primary literature was conducted by searching five databases: Medline, Embase, Cochrane, CINALH and PsycInfo. The initial search was run for a date spanning from the databases' inception to September 2018 and subsequently updated to dates spanning from October 2018 to May 2022. A systematic and iterative approach to data extraction was used. Thematic analysis was used to identify context-mechanism-outcome (CMO) configurations.

resultsAmong the 13,209 citations retrieved, 64 articles were included. This paper reports the top ten configurations found to facilitate or hinder eHealth implementation. Key themes related to context, such as team-based care, and action, including program use, perceived usefulness and motivation, are reported.

conclusionsThis study explores the role of context, mechanisms, and outcomes in ehealth implementation, highlighting the nonlinear relationships between these factors. Future implications include empirical testing CMOs as middle-range theories in real-world settings to determine causality.

trial registrationThe review protocol was registered with PROSPERO (CRD42020208275) on 1 October 2020.

Indexed as

Disease ManagementTelemedicineCanadaChronic DiseaseHumansChronic disease managementChronic kidney diseaseChronic obstructive pulmonary diseaseDiabeteseHealthHealth services researchHeart failureRealist reviewTelemedicine

Identifiers

PMID40176012
PMCPMC11966836

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.