Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed‐methods systematic review

Abstract

Inflammatory bowel disease (IBD) is a chronic illness that is comprised of two major disorders: Crohn's disease and ulcerative colitis. Adults with IBD have adopted telehealth and mobile health (mHealth) interventions to improve their selfmanagement skills and symptom-monitoring. This systematic review aimed to evaluate the efficacy of telehealth and mHealth interventions and explore the benefits and challenges of these interventions in patients with IBD. This review used a convergent segregated approach to synthesize and integrate research findings, a methodology recommended by the Joanna Briggs Institute for mixed-methods systematic reviews. Databases searched included PubMed, CINAHL, Embase, Cochrane Controlled Trials Registry, and ClinicalTrials.gov. The search followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, which yielded sixteen quantitative and two qualitative articles. A narrative synthesis was performed to present the findings of quantitative and qualitative studies. Evidence from quantitative and qualitative studies was then integrated for a combined presentation. The results of quantitative analysis supported the efficacy of telehealth and mHealth interventions to improve patients' quality of life, medication adherence, disease activity, medication monitoring, disease-related knowledge and cost savings. While some participants in qualitative studies reported certain challenges of telehealth and mHealth interventions, most of the participants conferred the benefits of the interventions, including improved disease-related knowledge, communication between patients and providers, sense of reassurance, and appointment options. The evidence from quantitative and qualitative synthesis partially supported each other. 1 | INTRODUCTION Inflammatory bowel disease (IBD) is a chronic illness of the gastrointestinal (GI) tract that mainly encompasses two major disorders: Crohn's disease (CD) and ulcerative colitis (UC; Lee, Kwon, & Cho, 2018). Active inflammation of the GI tract is the key factor behind IBD (Stein & Shaker, 2015). The clinical presentation of IBD includes abdominal pain, diarrhea, bowel urgency, rectal bleeding, weight loss, nutritional deficiencies, and many other extraintestinal manifestations (Stein & Shaker, 2015). Additionally, other symptoms, such as anxiety, depression, sleep disturbances, and fatigue, are highly prevalent in adults with IBD (Conley et al., 2017). This symptom burden, coupled with the remitting-relapsing nature of the disease and many other factors, including low social and family support, female gender,

The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

“…Patients’ care needs are different and, thus, should be tailored based on individuals’ situations. Healthcare professionals should care for patients depending on their specific physical (involving genetics/genomics), environmental (comprising epigenetics/epigenomics), mental, emotional, cultural, and spiritual needs [ 3 , 27 , 28 , 37 , 50 , 51 ].…”

“…Walker and Avant [ 30 ] introduced three basic approaches to theory building: derivation, synthesis, and analysis. This theory was synthesized through integrating the evidence, including empirical research and literature reviews, published by the theory-proposing author from 2015 to 2021 [ 3 , 9 , 10 , 13 , [18] , [19] , [20] , [21] , [22] , [25] , [26] , [27] , [28] , [29] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] ]. A summary of the theory-proposing author’s studies is listed in Table 1 .…”

“…Building nurse resilience should be an important focus for leaders. Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed-methods systematic review [ 51 ] Evaluate the efficacy of telehealth and mHealth interventions and explore the benefits and challenges of these interventions in patients with inflammatory bowel disease. The results of quantitative analysis supported the efficacy of telehealth and mHealth interventions to improve patients' quality of life medication adherence disease activity medication monitoring disease-related knowledge cost savings Applying a psychological nursing care quality evaluation index in hospitalized patients: A pilot study [ 52 ] Test the feasibility of a Psychological Nursing Quality Evaluation Index in hospitalized patients and increase patients’ self-care performance.…”

“…A significant phenomenon surfaced, which is self-care, including self-care for patients and healthcare professionals. These studies suggest that although organizations and work environments are essential for quality care and patients’ experiences in healthcare, self-care is the foundation for individuals’ health [ 36 , [49] , [50] , [51] , [52] ].…”

“…Optimal self-care of patients and healthcare providers is essential for improving health system performance. The findings of these studies show that healthcare professionals’ well-being is fundamental to ensure patient care quality and reduce healthcare costs [ 38 , 40 , 41 , [49] , [50] , [51] ]. The self-care studies led to some practical strategies to promote healthcare professionals’ resiliency building [ 19 , 22 , 43 , 44 , 47 , 48 ].…”