Applying M-Health to Palliative Care: A Systematic Review on the Use of M-Health in Monitoring Patients With Chronic Diseases and its Transposition in Palliative Care

Abstract

Background: The major growth of mobile technologies in the recent years has led to the development of medical-monitoring applications, particularly on smartphones. Aim: The aim of this study was to review the use of m-health in the monitoring of patients with chronic pathologies in order to consider what could be adapted for palliative care patients at home. Design: A systematic review of the English and French literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Date Sources: The review screened the following databases: PUBMED, SCOPUS, COCHRANE, SCIENCE DIRECT, SUDOC, and EM-Premium, screening studies published between 2008 and 2018. The selection of articles was done by the main investigator. All studies concerning the use of m-Health apps for patients with chronic diseases were included. Results: From the 337 selected publications, 8 systematic reviews and 14 original studies were included. The main uses of m-Health apps were biological and clinical monitoring (particularly concerning the symptoms) in 75% of the applications, disease self-management in 64% of the applications, and therapeutic patient education in 50% of the applications, with remote monitoring. Conclusions: The development of an m-Health application could become a complementary monitoring tool during palliative care. However, it seems important to question the impact of technique in the professional–patient relationship and avoid the pitfalls of standardizing palliative care and reducing the patient to a “sick” health technician. A future step would then be to define which health-care professional would be in charge of this “m-monitoring.”

Digital health interventions in palliative care: a systematic meta-review

“…Personal health monitoring devices, such as wrist-worn activity trackers and smartwatches are now widely used and have been evaluated in other digital health contexts 55 . The absence of evidence about the use of these may reflect the fact that most studies of trackers are taking place in the context of chronic disease management.…”

Digital Health Interventions in Palliative Care: A Systematic Meta-Review and Evidence Synthesis

“…Personal health monitoring devices, such as wrist-worn activity trackers and smartwatches are now widely used and have been evaluated in other digital health contexts. 56 The absence of evidence about the use of these may reflect the fact that most studies of trackers are taking place in the context of chronic disease management. Nevertheless, it suggests a need for further research in palliative care, particularly for patients managing at home, for whom wearables and ambient computing (e.g.…”

Hurdles to Developing and Scaling Remote Patients’ Health Management Tools & Systems: A Scoping Review

“…In some cases [4], [29], [30], [32], [33], [35] and [47], monitoring was combined either with prognosis or diagnosis of various diseases. In relatively few cases [2], [11], [12] [18] and [49], reviews discussed interventions which exclusively focused on prognosis, diagnosis or triage of patients without the requirement of continuous patient monitoring as part of the intervention.…”

“…A signi cant number of systematic reviews (nine) did not contain information about the extent to which discussed interventions integrated or intended to integrate with /-into traditional healthcare systems. Of the 26 reviews, 9 [4], [9], [12], [24], [29], [47], [31], [48] and [49] provided information to suggest or demonstrate that above integration was either achieved or at least attempted.…”

“…Systematic reviews generally discussed multiple diseases targeted with different, but often independent interventions. As demonstrated in gure 7, half of the reviews [2], [4], [10], [12], [24], [29], [31], [32], [35], [47], [49], [63] and [64] discussed multiple diseases but were largely not speci c to any one disease. Five [4], [10], [24], [31] and [63] actually identi ed diseases they targeted by name and the remaining 8 were not speci c to any particular disease.…”