eHealth technologies to manage chronic diseases in older adults
SUBJECT:
- Evidence and values to support the adoption of eHealth technologies for the management of chronic diseases in older adults.
ISSUE:
- Whether current evidence on their health and economic benefits is convincing to support wide adoption of eHealth technologies for chronic disease management in older adults.
BACKGROUND:
- Population aging is associated with growing numbers of older persons with chronic diseases, and an associated increasing demand for health care services. eHealth technologies hold promise as approaches for chronic disease management. These technologies can reduce barriers due to geographical location, health issues or time by bringing the health system and the care provider to the patient. Hence, eHealth can provide personalized care to older adults in their homes, improve health outcomes and reduce visits to acute care or the emergency department.
- Given economic constraints and the need to support evidence-based policy and decision-making, eHealth technologies should be evaluated for their health and economic benefit. A systematic review of the academic literature was conducted to understand the current state of the evidence on the use eHealth technologies for chronic disease management in older adults.
CONSIDERATIONS:
- Few studies have evaluated eHealth technologies in the management of chronic diseases in older adults. Available studies have evaluated the use of computerized decision support systems; web-based physical activity interventions; internet based cognitive behavioural therapy; telecare; or telehealth to manage diabetes, cardiovascular disease, congestive heart failure, cancer, chronic obstructive pulmonary disease, generalized anxiety disorder or depression.
- These studies were not conducted exclusively on older adults and have various limitations, including use of generic instruments to measure quality-of-life that might not be responsive to changes that are meaningful for older persons, uncertainty with efficacy/effectiveness and cost data, and show follow up periods (one year or less). Given the dearth of high quality studies that have examined the benefits of an eHealth technology in the management of a chronic disease in older adults it is difficult to reach any definitive conclusion as to whether the benefits of these technologies outweigh the additional costs.
CONCLUSIONS:
- The existing evidence that could support wide adoption and reimbursement of these technologies by public payers is inconclusive.
- Further research is warranted to demonstrate health and economic benefit of these eHealth technologies to manage chronic conditions and complex needs in older adults. These studies should preferable use both older adult specific generic quality-of-life measures to adequately capture the health status of older adults and allow comparison across studies.