Utilising Digital Health Technology to Support Patient-Healthcare Provider Communication in Fragility Fracture Recovery: Systematic Review and Meta-Analysis

Abstract

The objective of this review is to evaluate the effectiveness of digital health supported targeted patient communication versus usual provision of health information, on the recovery of fragility fractures. The review considered studies including older people, aged 50 and above, with a fragility fracture. The primary outcome was prevention of secondary fractures by diagnosis and treatment of osteoporosis, and its adherence. This review considered both experimental and quasi-experimental study designs. A comprehensive search strategy was built to identify key terms including Medical subject headings (MeSH) and applied to the multiple electronic databases. An intention to treat analysis was applied to those studies included in the meta-analysis and odds ratio was calculated with random effects. Altogether, 15 studies were considered in the final stage for this systematic review. Out of these, 10 studies were Randomised controlled trials (RCT) and five were quasi experimental studies, published between the years 2003 and 2016 with a total of 5037 participants. Five Randomised control trails were included in the meta-analysis suggesting that digital health supported interventions were overall, twice as effective when compared with the usual standard care (OR 2.13, 95% CI 1.30–3.48), despite the population sample not being homogeneous. Findings from the remaining studies were narratively interpreted.

“Context, content, and system” supporting digital health hub (DHH)–enabled models of care (MoCs) for fragility hip fractures: perspectives of diverse multidisciplinary stakeholders in South Australia from qualitative in-depth interviews

“…Moreover, with increasing access to information technology through computers and mobile applications, there is a growing recognition that people will become more curious to seek information related to their present health condition. Before undertaking this research, we conducted a comprehensive systematic review to evaluate the effectiveness of targeted patient communication supported through digital health interventions versus the standard provision of health information on the recovery from fragility fractures among older adults [ 1 ]. The findings from this review were divided into three categories as defined by the latest World Health Organization (WHO) guidelines on digital health interventions.…”

“…Fragility hip fractures among older adults present a significant burden to society in terms of disability, mortality, and economic repercussions for both community and health systems [1][2][3][4]. While the rate of fragility fractures in Australia is expected to rise by at least 10% every 5 years, hip fractures are among the most devasting of these fractures, with almost 50% requiring a permanent shift to residential aged Tiffany K. Gill and Mellick J. Chehade are joint senior authors care within 12 months [2].…”

“…The combined health and social care costs in the first year following a hip fracture injury are enormous and unsustainable; the costs are reported to be $43,669 on average, which is higher than equivalent estimates for ischemic stroke and acute coronary syndrome [3]. Hip fracture events are complex, manifested by disequilibrium of normal physiological processes at the individual patient level, and accompanied by inadequate management of multimorbid conditions at the health system level [1][2][3][4].…”

“…It is argued that the current health system is predominantly geared toward labeling and addressing chronic disease through siloed care pathways rather than having a wider view of disease etiology and interacting factors [6]. Thus, it is vitally important to acknowledge that the management of older people with fragility hip fractures is a complex, multidimensional issue that extends beyond the acute care facility and immediate discharge care [1,5,7].…”

A Home-Based eHealth Intervention for an Older Adult Population With Food Insecurity: Feasibility and Acceptability Study

“…These interventions are low-cost, personalized approaches capable of increasing the autonomy of older adults and their access to quality health care [16][17][18]. Emerging evidence shows that eHealth interventions for older adults have delivered promising results in terms of improving nutritional status [19] and physical activity [20,21] and have positive clinical outcomes for specific conditions such as fragility fracture [22] and cardiovascular disease [23]. However, unique characteristics of the lifestyle of older adults should be acknowledged to overcome the associated barriers before the wider implementations of eHealth interventions [18,19,24].…”