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Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries

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NPJ DIGITAL MEDICINE
卷 6, 期 1, 页码 -

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NATURE PORTFOLIO
DOI: 10.1038/s41746-023-00764-4

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Current evidence shows a disproportionate focus on high-income countries and hospital settings in digital health interventions. This review examines the use and effectiveness of digital health interventions for non-communicable disease management in low- and middle-income countries' primary healthcare settings. The study identifies factors influencing the uptake of these interventions and highlights the need for future research and practices to enhance their effectiveness.
Current evidence on digital health interventions is disproportionately concerned with high-income countries and hospital settings. This scoping review evaluates the extent of use and effectiveness of digital health interventions for non-communicable disease (NCD) management in primary healthcare settings of low- and middle-income countries (LMICs) and identifies factors influencing digital health interventions' uptake. We use PubMed, Embase, and Web of Science search results from January 2010 to 2021. Of 8866 results, 52 met eligibility criteria (31 reviews, 21 trials). Benchmarked against World Health Organization's digital health classifications, only 14 out of 28 digital health intervention categories are found, suggesting critical under-use and lagging innovation. Digital health interventions' effectiveness vary across outcomes: clinical (mixed), behavioral (positively inclined), and service implementation outcomes (clear effectiveness). We further identify multiple factors influencing digital health intervention uptake, including political commitment, interactivity, user-centered design, and integration with existing systems, which points to future research and practices to invigorate digital health interventions for NCD management in primary health care of LMICs.

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