Background eHealth has the potential to improve outcomes such as physical activity or balance in older adults receiving geriatric rehabilitation. However, several challenges such as scarce evidence on effectiveness, feasibility, and usability hinder the successful implementation of eHealth in geriatric rehabilitation. Objective The aim of this systematic review was to assess evidence on the effectiveness, feasibility, and usability of eHealth interventions in older adults in geriatric rehabilitation. Methods We searched 7 databases for randomized controlled trials, nonrandomized studies, quantitative descriptive studies, qualitative research, and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated a combination of effectiveness, usability, and feasibility of eHealth in older patients who received geriatric rehabilitation, with a mean age of ≥70 years. Quality was assessed using the Mixed Methods Appraisal Tool and a narrative synthesis was conducted using a harvest plot. Results In total, 40 studies were selected, with clinical heterogeneity across studies. Of 40 studies, 15 studies (38%) found eHealth was at least as effective as non-eHealth interventions (56% of the 27 studies with a control group), 11 studies (41%) found eHealth interventions were more effective than non-eHealth interventions, and 1 study (4%) reported beneficial outcomes in favor of the non-eHealth interventions. Of 17 studies, 16 (94%) concluded that eHealth was feasible. However, high exclusion rates were reported in 7 studies of 40 (18%). Of 40 studies, 4 (10%) included outcomes related to usability and indicated that there were certain aging-related barriers to cognitive ability, physical ability, or perception, which led to difficulties in using eHealth. Conclusions eHealth can potentially improve rehabilitation outcomes for older patients receiving geriatric rehabilitation. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation, especially, in combination with another non-eHealth intervention. However, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise, but more research is required, including research with a focus on usability and participation.

While eHealth can help improve outcomes for older patients receiving geriatric rehabilitation, the implementation and integration of eHealth is often complex and time-consuming. To use eHealth effectively in geriatric rehabilitation, it is essential to understand the experiences and needs of healthcare professionals. In this international multicentre cross-sectional study, we used a web-based survey to explore the use, benefits, feasibility and usability of eHealth in geriatric rehabilitation settings, together with the needs of working healthcare professionals. Descriptive statistics were used to summarize quantitative findings. The survey was completed by 513 healthcare professionals from 16 countries. Over half had experience with eHealth, although very few (52 of 263 = 20%) integrated eHealth into daily practice. Important barriers to the use or implementation of eHealth included insufficient resources, lack of an organization-wide implementation strategy and lack of knowledge. Professionals felt that eHealth is more complex for patients than for themselves, and also expressed a need for reliable information concerning available eHealth interventions and their applications. While eHealth has clear benefits, important barriers hinder successful implementation and integration into healthcare. Tailored implementation strategies and reliable information on effective eHealth applications are needed to overcome these barriers.

BACKGROUND eHealth has the potential to improve outcomes in older adults receiving geriatric rehabilitation. However, evidence on (cost)effectiveness in post-acute geriatric rehabilitation is scarce, and the successful implementation and use of eHealth in geriatric rehabilitation is not self-evident. OBJECTIVE The aim of this systematic review is to assess the effectiveness, usability and feasibility of eHealth interventions in older adults in geriatric rehabilitation. METHODS Seven databases were searched for randomized controlled trials, non-randomized studies, quantitative descriptive studies, qualitative research and mixed methods studies that applied eHealth interventions during geriatric rehabilitation. Included studies investigated effectiveness, usability and/or feasibility of eHealth in older patients with a mean age of ≥70 who received geriatric rehabilitation. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a narrative synthesis was conducted using a Harvest plot. RESULTS In total 34 were selected, with clinical heterogeneity across studies, and high exclusion rates reported in 7studies. Outcomes related to participation and usability were infrequently reported. In 16 studies eHealth was found to be at least as effective as non-eHealth interventions (73% of the included studies with a control group), 6 studies found eHealth interventions to be more effective than non-eHealth interventions (27%), and 2 studies reported beneficial outcomes in favor of the non-eHealth interventions (9%). Overall, the identified studies showed that eHealth is often feasible and can potentially improve rehabilitation outcomes, especially in combination with another (non)eHealth intervention. Simple eHealth interventions were more likely to be feasible for older patients receiving geriatric rehabilitation. CONCLUSIONS Current evidence on eHealth in older patients receiving geriatric rehabilitation is diverse, making it challenging to compare outcomes and draw conclusions. Furthermore, a lack of evidence on usability might hamper the implementation of eHealth. eHealth applications in geriatric rehabilitation show promise but more research is required, including research with a focus on usability and participation