JMIR Publications

ABSTRACT

Background:

With time constraints and the COVID-19 pandemic, health care professionals increasingly depend on technology to provide health advice and teach patients how to manage chronic disease. The effectiveness of video-based tools in improving knowledge, health behaviors, disease severity, and health care utilization for patients with major chronic illnesses is not well understood.

Objective:

To assess the current literature regarding the efficacy of video-based tools for patients in improving process and outcome measures across several chronic illnesses.

Methods:

A systematic review was conducted using CINAHL and PubMed with predefined search terms. Intervention studies of video-based self-management patient education for an adult patient population with the following chronic health conditions: asthma, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), chronic pain syndromes, diabetes, heart failure, human immunodeficiency virus (HIV), hypertension, inflammatory bowel disease (IBD), and rheumatologic disorders were eligible. Eligible papers underwent full extraction of study characteristics, study design, sample demographics, and results. Bias was assessed with Cochrane risk of bias tools. Summary statistics were synthesized in STATA.

Results:

From 112 studies fully extracted, 59 were deemed eligible (52.7%). The majority of included papers were superiority randomized controlled trials (RCTs, 66%), with fewer pre/post studies (22%) and non-inferiority RCTs (12%). The most represented conditions of interest were obstructive lung disease (31%), diabetes (19%), and heart failure (15%). The plurality (47%) of video-based interventions only occurred once and occurred alongside adjunct interventions including printed materials, in-person counseling, and interactive modules. The most frequently studied outcomes were disease severity, health behavior, and knowledge. Video-based tools were most effective in improving patient knowledge. Approximately half of reported health behavior (56%) and patient self-efficacy (52%) outcomes were improved by video-based tools, and a minority of health care utilization (41%) and disease severity (33%) outcomes were improved by video-based tools. In total, 43.2% of RCTs and 66% of non-RCTs had moderate or high risk of bias.

Conclusions:

There is robust evidence that video-based tools can improve patient knowledge across several chronic illnesses. These tools less consistently improve disease severity and health care utilization outcomes. Additional study is needed to identify features that maximize the efficacy of video-based interventions for patients across the spectrum of digital competencies to ensure optimized and equitable patient education and outcomes. Clinical Trial: Not Applicable