eHealth Apps Replacing or Complementing Health Care Contacts: Scoping Review on Adverse Effects (Preprint)

Abstract

Background:The use of eHealth has increased tremendously in recent years. eHealth is generally considered to have a positive effect on healthcare quality and to be a promising alternative for face-to-face healthcare contacts. Surprisingly little is known about possible adverse effects of eHealth applications. Objective:We conducted a scoping review on empirical research into adverse effects of eHealth applications that aim to deliver healthcare on a distance. We investigated if adverse effects were reported and the nature and quality of research into these possible adverse effects. Methods:For this scoping review, we followed the five steps of Arksey and O'Malley's scoping review methodology. We examined the literature between December 2012 and August 2017 in the following databases: PubMed, CINAHL, Web of Science and the Cochrane Library. Each paper was independently screened by at least two authors; differences were resolved through consensus development. Study characteristics were extracted. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) lists. Results related to the research question were described and categorized. Results:Our search identified 79 papers that were potentially relevant; 11 studies met our inclusion criteria after screening. These studies differed in many ways and the majority was characterized by small research populations and low study quality. Despite the shortage of solid research, we found some indications of possible adverse effects Conclusions:There is a lack of high-quality empirical research on adverse effects of eHealth applications replacing or complementing face-to-face care. While the development of eHealth applications is ongoing, the knowledge with regard to possible adverse effects is limited. The available research focuses often on efficacy, added value, implementation issues, use and satisfaction, whereas adverse effects are underexposed. A better understanding of possible adverse effects might be a starting point to improve the positive impact of eHealth-based health care delivery.