JMIR Publications

ABSTRACT

Background:

Multimorbidity, defined as the coexistence of two or more chronic conditions, challenges traditional, single-disease health care models. While digital health technologies are increasingly applied to complex patient care, most interventions remain disease-specific and fail to capture interactions between coexisting conditions. Understanding how current eHealth approaches address multimorbidity as an interconnected phenomenon is crucial for advancing integrated, patient-centered care.

Objective:

This scoping review systematically maps existing evidence on digital health interventions that explicitly address multimorbidity, focusing on how these solutions integrate disease interdependencies into their design, implementation, and evaluation.

Methods:

Following the PRISMA-ScR guidelines, systematic searches were conducted in PubMed and CINAHL for studies published in English or German between January 2014 and May 2024. Eligible studies described eHealth interventions for managing two or more chronic conditions with attention to disease interaction and integration mechanisms.

Results:

From 1.660 records, 11 studies representing seven distinct digital health projects met the inclusion criteria. Most interventions focused on older adults with cardiometabolic or respiratory multimorbidity and combined mobile applications, telemonitoring platforms, and decision-support or analytic modules. Although digital tools were generally feasible and well accepted by patients and professionals, few incorporated mechanisms for modelling interdependencies between coexisting conditions or for reconciling overlapping clinical guidelines. Evaluation outcomes mainly addressed usability, engagement, and feasibility, while robust assessments of clinical effectiveness or long-term outcomes were scarce. Evidence suggests that meaningful multimorbidity management and cross-disease data management remains largely at a conceptual or pilot stage. The key concepts for management of multimorbidity reported in the included studies incorporate structured care models, integrated care management and standardized documentation of health profiles.

Conclusions:

Digital health approaches to multimorbidity remain fragmented and largely exploratory. Current evidence demonstrates feasibility and user acceptance but limited operationalization of true multi-disease management. Future research should focus on co-designed, interoperable systems that integrate data across conditions and support adaptive, AI-driven decision-making. Developing supportive human infrastructures, such as community or triage nurses, will be essential to translate digital innovations into sustainable, equitable multimorbidity care.