JMIR Publications

ABSTRACT

Background:

More adolescents with chronic physical illness are living into adulthood and require the development of proficient self-management skills to maintain optimal physical health as they transition into adult care services. It is often during this vulnerable transition period that deterioration in illness control is seen as a result of inadequate self-management skills and understanding of their chronic illness. Mobile technology has been proposed as an innovative opportunity to assist in improving the management of chronic conditions as young people transition to adult care services. Over the past five years, there has been a significant increase in research into the use of health-related applications.

Objective:

To evaluate the utility and effectiveness of mobile and/or web-based health applications that support self-management and transition in young people with chronic physical health illnesses.

Methods:

We conducted a comprehensive review of the literature in five bibliographic databases using key search terms, considering only articles published from 2013 onwards, as we are extending the data from two previous systematic reviews. Abstracts were screened for possible inclusion by two reviewers. Data extraction and quality assessment tools were used for the evaluation of the included studies.

Results:

A total of 1737 records were identified from the combined electronic searches, 854 were removed as duplicates. Sixty-eight full articles were further assessed for eligibility, six met our review criteria: three pilot studies, two randomized controlled trials and one prospective cohort study. Publication years ranged from 2015 to 2018. The applications reported were targeted at type 1 diabetes mellitus, epilepsy, asthma, beta thalassemia major and sickle cell disease, with a combined sample size of 336. Four of the studies included in this review reported being effective in increasing knowledge of the targeted condition and increasing therapy adherence, including increased medication adherence. Two manuscripts only mentioned the word ‘transition’. Participant’s satisfaction was reported for all studies. Heterogeneity of the studies prevented meta-analysis.

Conclusions:

There remain limited data on the effectiveness and use of mobile and/or web-based applications which might facilitate the transition of adolescents with chronic illnesses from paediatric to adult health care services. This systematic review provides an up dated overview of available applications for adolescences with chronic illnesses. This systematic review has been unable to provide evidence for effectiveness of this approach but does provide insights into future study design with reference to the development, evaluation and efficacy of applications tailored for adolescents with chronic illnesses, including the involvement of adolescents in such designs.