Background: Access to health information is critical to enable consumers to participate in decisions on health. Increasingly, such information is accessedvia the internet, but a number of barriers prevent consumers making effective use of it. These barriers include inadequate skills to search, evaluate and use the information. It has not yet been demonstrated whether training consumers to use the internet for health information can result in positive health outcomes. OBJECTIVES: To assess the effects of interventions for enhancing consumers' online health literacy (skills to search, evaluate and use online health information). Search strategy: We searched: the CochraneConsumers and Communication Review Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library,Issue 1 2008); MEDLINE (Ovid); EMBASE (Ovid); CINAHL (Dialog); ERIC (CSA Illumina); LISA (CSA Illumina); PsycINFO (Ovid); Index to scientific and technical proceedings; SIGLE; ASLIB Index to Theses; ProQuest Dissertation Abstracts; National Research Register/UK CRN Portfolio database; Current Controlled Trials - MetaRegister of Controlled Trials. We searched all databases for the period January 1990 to March 2008. Selection criteria: Randomised controlled trials (RCTs), cluster RCTs and associated economic evaluations, quasi-RCTs, interrupted time series analyses, and controlled before and after (CBA) studies assessing interventions to enhance consumers' online health literacy, in any language. Data collection and analysis: Two review authors independently selected studies for inclusion, assessed their quality and extracted data. We contacted study authors for clarification and to seek missing data. We presented results as a narrative and tabular summary,and calculated mean differences where appropriate. (Abs. trunc. at 2000 ch.)
COBISS.SI-ID: 29499097
Background: There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. Methods and findings:We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews thatfocused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providingrelevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We foundthat despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployedbeyond the contexts in which they were originally developed, has yet to be established. (Abs. trunc. at 2000 ch.)
COBISS.SI-ID: 28103129
Background: Telehealthcare has the potential to provide care for long-term conditions that are increasingly prevalent, such as asthma. We conducted a systematic review of studies of telehealthcare interventions used for the treatment of asthma to determine whether such approaches to care are effective. Methods: We searched the Cochrane Airways Group Specialised Register of Trials, which is derived from systematic searches of bibliographicdatabases including CENTRAL (the Cochrane Central Register of Controlled Trials), MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and PsycINFO, as well as other electronic resources.We also searched registers of ongoing and unpublished trials. We were interested in studies that measured the following outcomes: quality of life, number of visits to the emergency department and number of admissions tohospital. Two reviewers identified studies for inclusion in our meta-analysis. We extracted data and used fixedeffect modelling for the meta-analyses. Results: We identified 21 randomized controlled trials for inclusion in our analysis. The methods of telehealthcare intervention these studies investigated were the telephone and video- and Internet-based models of care. Meta-analysis did not show a clinically important improvement in patients' quality of life, and there was no significant change in the number of visits to the emergency department over 12 months. There was a significant reduction in the number of patients admitted to hospital once or more over 12 months (risk ratio 0.25 š95% confidence interval 0.09 to 0.66đ). Interpretation: We found no evidence of a clinically important impact on patients' quality of life, but telehealthcare interventions do appear to have the potential to reduce the risk of admission to hospital, particularly for patients with severe asthma. (Abs. trunc. at 2000 ch.)
COBISS.SI-ID: 29508569