Use of digital technology among patients with multiple long-term conditions: a qualitative systematic review

Background: The prevalence of multiple long-term conditions (MLTCs) is increasing internationally. More common in older people and those from disadvantaged communities, MLTCs can generate substantial treatment expenditure, presenting a global challenge for healthcare systems. Digital technologies offer an opportunity to support self-management in the community, reducing pressures on patients and healthcare systems. Aim: To appraise and synthesise qualitative literature exploring patients’ experiences of using digital technology to manage MLTCs. Design & setting: Systematic review of international literature. Method: We searched MEDLINE, CINAHL, PsycInfo, Embase, and PubMed (to October 2023), with backward and forward citation searches (January 2024) for studies exploring patients’ experiences of managing MLTCs using digital technologies. We used Critical Appraisal Skills Programme (CASP) for quality assessment. Results: Fourteen reports (13 studies) were included, predominantly from North America. We included studies exploring patients’ experiences of internet use for health information, peer-support videoconferencing, electronic personal health records, and apps or digital systems for home telemonitoring. Three themes explored (1) patients’ lived experience, (2) key components of digital technologies, and (3) potential benefits of well-designed digital technology. Patient experiences with digital health technologies are influenced by their health literacy, trust in providers, and existing self-management practices. Patients need simple, patient-centred, and user-tested digital health tools. If successful, they may empower patients, and improve access and communication with healthcare professionals. Poorly designed tools risk disengagement. Healthcare professionals need training and capacity to support collaborative use. Conclusion: Digital technologies may empower patients’ self-management. Patient-centred design is key to support potential benefits, making sure not to exacerbate patient and healthcare professional burden and inequalities.