JMIR Publications

ABSTRACT

Background:

Endometriosis is a chronic disease that affects one in ten women worldwide. The disease affects patients’ daily life at physical, psychological and social levels. In recent years, the management of this disease has evolved, thanks in particular to the emergence of digital technologies and associated interventions. However, despite their growing use, there seems to be no systematic review of their development, design and efficacy.

Objective:

A systematic review was conducted with the aim of characterising the development process, design and effectiveness of interventions using a digital tool for endometriosis.

Methods:

Six databases (MEDLINE, APA PsycArticles, Psychology and Behavioral Sciences Collection, APA PsycInfo, SocINDEX, SPORTDiscus) were searched to identify relevant articles published between 2010 and 2024. The articles selected were analysed using a methodological framework specific to the development of digital health interventions (DEDHI), consisting of four phases: preparation (phase 1, specific to application development), optimization (phase 2, dedicated to identifying the best intervention configurations), evaluation (phase 3, aiming to confirm the effectiveness of the intervention), and implementation (phase 4, implementation and updating the intervention on a large scale).

Results:

A selection of 10 articles was made from the 381 studies retrieved from the databases. Among these 10 studies, 6 distinct digital interventions (DHI) were identified. The interventions based on digital devices produced physical and/or psychological benefits. Analysis using the DEDHI framework showed: (1) a disparity in the responses to the different phases (i.e., 90% of studies responding to phase 1, 30% phase 2, 40% phase 3 and 20% phase 4), and (2) a variability in the completion of the evaluation criteria ranging from 10 to 80% in the first phase, from 0 to 77% in phase 2, from 0 to 80% in phase 3 and finally from 0 to 77% in phase 4. The objectives of these digital interventions were to support pain management (i.e., 5 out of 6 DHIs), to provide information about the disease and strategies for managing it (4 out of 6) and to provide psychosocial support (2 out of 6).

Conclusions:

This systematic review highlights an emerging literature, limited regarding the use of digital technology in the management of endometriosis, and heterogeneous concerning the methodologies used. This variability limits the generalisability of the results and requires a nuanced interpretation of the available data. However, the results of this review have demonstrated the value of digital technology-based interventions to support endometriosis, while highlighting the importance of a methodological framework to structure their development, in order to optimise patient support.