Patients’ and healthcare professionals’ perspectives towards technology-assisted diabetes self-management education. A qualitative systematic review

Abstract

Introduction Diabetes self-management education is a key aspect in the long-term management of type 2 diabetes. The patient and healthcare professional (HCP) perspective on the use of technology-assisted DSME has yet to be studied. Hence, the objective of this study was to better understand the factors that facilitate or hinder the adoptions of such education by adults with type 2 diabetes and their HCPs. Methods We systematically searched five databases (Medline, Embase, CINAHL, Web of Science Core Collection, and PsycINFO) until August 2019. The search included qualitative and mixed-method studies that reported the views of patients and HCPs regarding features, uses, and implementations of technology-assisted DSME. Data were synthesized through an inductive thematic analysis. Results A total of 13 articles were included, involving 242 patients, ranging from 18 to 81 years and included web-based, mobile application, digital versatile disc (DVD), virtual reality or telehealth interventions. Patients and HCPs had mixed views towards features of the technology-assisted interventions, with patients' personal qualities and HCPs' concerns affecting uses of the interventions. Patients generally preferred technologies that were easy to access, use, and apply and that had reliable information. Patients' ambitions motivated them, and personal attributes such as poor competence with technology, poor literacy, and language barriers acted as barriers. Patients especially liked the peer support that they

The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews

“…In SM educational programmes for T2DM or COPD, most patients reported increased confidence when getting prompt, tailored advice from qualified and competent healthcare professionals [ 41 , 155 , 161 ]. They used the information as a motivator and supported technologies that allowed them to receive support from healthcare teams [ 161 ].…”

“…In SM educational programmes for T2DM or COPD, most patients reported increased confidence when getting prompt, tailored advice from qualified and competent healthcare professionals [ 41 , 155 , 161 ]. They used the information as a motivator and supported technologies that allowed them to receive support from healthcare teams [ 161 ]. Increased knowledge provided a greater sense of control [ 41 ], increased confidence in SM intervention, improved communication with healthcare professionals, reduced fears of deterioration, prevented hospitalisation, improved anxiety and depression, and increased ability to deal with negative emotions [ 132 , 155 ].…”

“…However, some others felt uncomfortable since it often required a steep learning curve [ 34 , 172 ], which, in some cases, produced “technology anxiety” [ 34 ]. In technology-assisted programmes, a lack of technical skills and the complexity and difficulty of text messaging or editing their data were barriers in T2DM [ 161 ] and obesity [ 87 ].…”

“…Individualised Care Across the four chronic diseases, patients valued and responded better to education and advice tailored to their changing needs over time and to their personal factors [ 153 , 155 , 161 , 173 ], but healthcare professionals did not always do this [ 95 ]. Patients valued being heard by their healthcare professionals and appreciated when they enquired about their personal circumstances [ 99 , 155 ].…”

“…Supportive relationships helped motivate attendance at programmes and promote healthy eating and exercise [ 132 , 175 ]. Some patients did not participate in forums and preferred to keep their privacy or real-life contacts [ 161 ]. Informal caregivers of patients with HF found support groups useful [ 144 ].…”