Do technology-based interventions work for older adults with chronic diseases? : Systematic Review and Meta-analysis

The purpose of this systematic review and meta-analysis (SR & MA) is to examine how features of intervention and methodological qualities of study are related to the effectiveness of technology-based interventions for middle aged and older adults (N=9,110) with chronic illnesses. Six databases (e.g., CENTRAL, CINAHL, Cochrane, Medline, PsycINFO, and PubMed) were used. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was employed as standards for reporting our SR and MA (Moher et al., 2009). Thirteen articles were selected in terms of 11 criteria of methodological quality (Miller et al., 2003) such as random assignment and follow-up rate. Additionally, we evaluated 11 intervention features (Neve et al., 2010) including individualized information, self-monitoring, etc.; and effectiveness of self-management via a technology-based intervention.

The results revealed lower levels of methodological qualities and features. More than a half (54%) of the selected studies were less than 10 methodological quality scores (out of 17, range: 4-15); and 85% were less than 6 features scores (out of 11, range: 1-6). Only three articles revealed significant effectiveness of intervention for managing chronic illnesses. No significant correlations among methodological qualities, features, and effectiveness were found. Additionally, two meta-analyses allowed us to compare outcome measurements, specifically participation rates for Colorectal Cancer screening and Fecal Occult Blood Testing between intervention and control groups. However, there were no significant differences between the two groups.

These results suggest methodological quality and features be integrated into improving the effectiveness of the technology-based interventions for chronic diseases. Further implications will be discussed.