Article
Electronic patient-generated health data to facilitate primary prevention and health promotion: a systematic scoping review
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Published: | March 20, 2019 |
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Background/research question: Healthcare systems face demographic and chronic disease challenges that can possibly be approached by a paradigm shift towards pro-active, patient-centred and preventive practice. Our study explored the use of electronic Patient-Generated Health Data (ePGHD), defined as health-data, created by patients or their designees, as a potential facilitator of that paradigm shift [1]. The review’s objective is to establish a comprehensive understanding of ePGHD use for prevention and health promotion.
Methods: A comprehensive search of seven electronic databases and a range of grey literature sources, guided by Arksey and O’ Malley’s methodological framework, performed in January 2018. Any type of empirical and grey literature with a focus on ePGHD and linked to prevention and health promotion was eligible for inclusion. The review process, guided by protocol [2], was conducted by two independent reviewers and followed by a narrative synthesis approach.
Results: Inclusion of 183 highly heterogeneous studies, with the majority addressing weight control (n=124), overall well-being (n=20), cardiometabolic health (n=14) and substance use prevention (n=13). Most common PGHD aims include
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- behavior modification
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- knowledge enhancement
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- “healthy contexts” promotion and
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- surveillance support.
Generated via a variety of tools, ranging from socially-penetrated devices (n=157) to medical technologies (n=15); 94% of the literature combined ePGHD with additional components, such as motivational (n=123) or educational elements (n=116). The interpretation of ePGHD is key (n=160) but mostly indirectly described in form of educational and instructive support, comparative and normative feedback, summaries and visualizations. The preventive impact of ePGHD is mixed with positive tendencies, while the consideration of equity effects remains weak. Barriers and facilitators where clustered around
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- data generation,
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- technicalities,
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- ethics and trust,
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- user characteristics and
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- context.
Conclusions: Our review maps a heterogeneous volume of ePGHD literature and enhances our understanding on the use of such data for prevention and health promotion. Mostly embedded in multicomponent interventions, the actual value of ePGHD for prevention is difficult to disentangle. Future research should explore which combinations of supportive elements and ePGHD work best, and for which preventive measures, placing emphasis on equity and key identified barriers and facilitators.
Competing interests: None
References
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- Shapiro M, Johnston D, Wald J, et al. Patient-generated health data White Paper. Research Triangle Park, NC: RTI International; 2012.
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- Nittas V, Mütsch M, Ehrler F, Puhan MA. Electronic patient-generated health data to facilitate prevention and health promotion: a scoping review protocol. BMJ Open. 2018 Aug 10;8(8):e021245. DOI: 10.1136/bmjopen-2017-021245