A systematic review on randomized controlled trials: Coaching elements of digital services to support chronically ill adolescents during transition of care

Abstract

Aims:To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes.Design: Systematic review without meta-analysis. Interventions and reported according to the Preferred Reporting Items for SystematicReviews and Meta-analyses statement. Results: Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. Conclusion: E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. Impact: Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care. K E Y W O R D S chronically ill adolescent, digital health services, e-coaching, health behaviour, health coaching, nursing, self-management, support, systematic review, transition of care

Effectiveness of technological interventions to improve healthcare communication with children with long-term conditions: A systematic review and meta-analysis of randomised controlled trials

“…Meta- This review used established guidance and validated tools, thus was methodologically rigorous [23,24,28]. Using inclusive eligibility criteria for all LTCs and technological interventions supports generalisability within the field of child health, compared to other published works [13][14][15][16][17][18][19][20]. Meta-analysis of adequately reported outcomes was undertaken, overcoming issues such as small sample sizes within individual studies.…”

“…interventions [14,15,18,19] or outcomes [13,16], often aimed at adolescents transitioning to adult healthcare services [13,17,18,20]. This review provides a broader appraisal of the current evidence, encompassing all technological communication interventions aimed at children without restriction on type of LTC.…”

“…Previous literature reviews in the child health setting have focused mainly on the use of technology for specific conditions or modalities of communication [13][14][15][16][17][18][19][20]. Many place particular emphasis on improving adolescents' self-management during the transition to adult healthcare services, with varying levels of success [13,17,18].…”

Adherence to r-hGH Therapy in Pediatric Growth Hormone Deficiency: Current Perspectives on How Patient-Generated Data Will Transform r-hGH Treatment Towards Integrated Care

“…Addressing the patients' and caregivers' perspectives is crucial, especially in areas where digital health interventions are supporting medication adherence or other long-term self-management behaviors. In the case of digital interventions in pediatrics, a key aspect to consider is the interplay between caregivers and patients especially during the transition to adult care 18 or patient-initiated medication. For example, a key moment to intervene is when injections are transitioning from being delivered by the caregivers to the children themselves.…”

Efficacy of Health Coaching and an Electronic Health Management Program: Randomized Controlled Trial

“…In order to improve self-management, numerous health coaching interventions have been developed. 3,4 However, these health interventions were mostly targeted to patients with diabetes, cardiovascular disease such as hypertension, and cancer, and most of them are based on patient education. 3 Long-term health outcomes depend on sustaining selfmanagement strategies.…”