Digital Health Interventions to Support Chronic Disease Management: Systematic Scoping Review.

Background: Health interventions delivered by digital platforms are gaining popularity and are evolving to address the needs of patients with chronic diseases. The heterogeneity of chronic diseases requires that digital health platforms vary in their approaches to chronic disease management. Objective: This review aimed to explore the characteristics of digital health platforms and the corresponding digital interventions developed to support patients with chronic diseases. This includes those platforms' design, development, and the metrics by which any incremental benefits they provide are assessed. Methods: We searched electronic databases including Scopus, Web of Science, PsycINFO, IEEE Xplore, MEDLINE, and Embase. Relevant articles published from January 2013 to November 2024 were extracted. Extracted data were then synthesized using qualitative content analysis and presented in narrative form with relevant tables. Results: In total, we identified 69 digital health platforms supporting the management of 20 chronic diseases. Most platforms were mobile apps (n=22) or a combination of web and mobile apps (n=15). Most of the platforms (n=44) were tailored to support self-management of chronic diseases. These platforms also provided a web-based portal where health care providers could review and manage the information recorded by patients. In 77% (53/69) of the studies, patients reported that the digital interventions delivered by the platform improved their quality of life, their health, and their ability to self-manage their chronic diseases. In addition, health care providers reported positive outcomes, including improved clinical utility and patient communication. While short-term health outcomes of the digital health interventions were largely positive, long-term health outcomes remain unknown. This was because most of the studies were short-term pilots and often formative in nature (n=42). Many had limited sample sizes, limited participant uptake of the digital platforms, and technical issues. In many cases, further personalization of platforms was required to meet patients' self-management needs. Conclusions: Digital health interventions can be beneficial in the management of chronic disease. The adoption of digital interventions in combination with regular clinical care can improve health outcomes, support self-management, and enhance communication between patients and health care providers. However, long-term user engagement is the major barrier to their long-term success. High dropout rates, often resulting from a lack of motivation or technical issues, testify to the need for adaptive, low-burden interventions that function seamlessly in users' daily lives. Adopting user-centered and co-design approaches that engage both clinicians and patients in designing digital health platforms may enhance the usability and uptake of such platforms.