Information Technology to Support Self-Management in Chronic Care A Systematic Review

Informed individuals who are actively engaged in managing the daily challenges of their chronic disease are the change agents in a healthcare system that is presently unresponsive to the needs of this growing population. The application of information technology (IT) to support self-management extends the reach of the provider organization by linking patients to the exchange of health information and facilitating self-management activities. This systematic review of the literature was conducted to illuminate the application of IT that is enabling consumer self-management and healthcare provider support of that self-management. Research in self-management IT is being conducted to determine the effectiveness of various tools in improving self-management performance and health outcomes. A significant area of inquiry focuses on self-managernent technologies to support the chronic care model (CCM) conceived by Wagner and colleagues. Results indicate that most research is focused on the use of IT by individuals for self-education and self-monitoring, with a small number of studies exploring applications to enable collaboration of providers and individuals in self-management planning and activities. Changes in patient adherence and levels of knowledge were the most popular outcome variables measured, with reports of significant improvements in both areas. However, limitations in study design have led to inconclusive results regarding the effect of IT-based self-management tools on patient adherence and clinical outcomes. This systematic review affirms the importance of extending the IT infrastructure of the healthcare system to support the self-management activities of individuals striving to manage their chronic disease.