JMIR Publications

ABSTRACT

Background:

The rising prevalence of non-communicable diseases (NCDs) worldwide and the high recent mortality rates (74.4%) associated with them, especially in developing countries, is causing a substantial global burden of diseases, necessitating innovative and sustainable long-term care solutions.

Objective:

This scoping review aims to investigate the impact of Artificial Intelligence (AI)-based conversational agents (CAs) - including chatbots, voicebots, and anthropomorphic digital avatars, as human-like health caregivers in the remote management of NCDs; as well as identify critical areas for future research and provide insights into how these technologies might be used effectively in healthcare to personalize NCD management strategies.

Methods:

A broad literature search was performed in July 2023 using six electronic databases - Ovid Medline, CINAHL, EMBASE, PubMed, PsycInfo, and Web of Science with search terms “conversational agents”, “artificial intelligence”, and “non-communicable diseases”, including their associated synonyms. We also manually searched grey literature using ProQuest Central, ResearchGate, Association for Computing Machinery Digital Library (ACM DL), and Google Scholar. We included empirical studies published in English from 2010 to July 2023, focusing solely on healthcare-oriented applications of CAs employed for remote management of NCDs. The narrative synthesis approach collated and summarised the relevant information extracted from the included studies.

Results:

The literature search yielded 43 studies that matched the inclusion criteria. Our review unveils four significant findings: (1) Higher user acceptance and compliance with anthropomorphic and avatar-based CAs for remote care; (2) an existing gap in the development of personalized, empathetic, and contextually aware CAs for effective emotional and social interaction with users, along with limited consideration of ethical concerns like data privacy and patient safety; (3) Inadequate evidence of efficacy of CAs in NCD self-management, despite a moderate to high level of optimism among healthcare professionals regarding CAs' potential in remote healthcare; and (4) CAs are primarily used for supporting non-pharmacological interventions like behavioural or lifestyle modifications and patient education for self-management NCDs.

Conclusions:

This paper makes a unique contribution to the field by providing a quantifiable impact analysis and identifying the areas requiring imminent scholarly attention for AI's ethical, empathetic, and efficacious implementation in NCD care. This serves as an academic cornerstone for future research in AI-assisted healthcare for NCD management.