Targeted Digital Health Intervention in End-of-Life and Hospice Care: A Scoping Review

针对临终关怀和安宁疗护的定向数字健康干预:范围界定综述

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Abstract

AIM: Digital health interventions, including health analytics, telehealth, mHealth and digitised healthcare systems, are rapidly advancing and demonstrate effectiveness in palliative care. Although end-of-life (EOL) and hospice care are within palliative care, they differ in outcomes, target populations and delivery systems. This review examines research trends to guide digital health strategies for EOL and hospice care. DESIGN: Scoping review. DATA SOURCES: Systematic searches in CINAHL, MEDLINE, SCOPUS, EMBASE, Cochrane and Web of Science identified studies from 2019 to 2023 using keywords 'end of life', 'hospice' and 'digital health'. METHODS: Following the Joanna Briggs Institute framework, two reviewers independently screened studies, extracted data and categorised health challenges and digital health types per World Health Organization and Deloitte classifications. RESULTS: Among 4342 studies, 38 met the inclusion criteria. Most were retrospective (36.8%) without control groups (68.3%). Key targets included healthcare systems (44.2%) and patients (25.6%), focusing on health analytics (44.7%) and mHealth (23.7%) for EOL transitions and symptom management. Main challenges included utilisation (34.9%), efficiency (32.6%) and quality (30.2%). CONCLUSION: Digital health interventions hold potential for enhancing EOL and hospice care but face challenges such as study design limitations, appropriate modality selection, rapport-building and risks of exacerbating health inequalities. Future interventions should emphasise human-centred digital capabilities for healthcare providers and user-centred designs. IMPACT: This review highlights opportunities for digital health to improve quality of life for EOL and hospice patients and caregivers. The insights provide guidance for applying digital health interventions in different settings and highlight the importance of equipping healthcare providers with human-centred digital competencies. REPORTING METHOD: The reporting was guided by the PRISMA extension for scoping reviews (PRISMA-ScR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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