A study published in the Journal of Medical Internet Research (JMIR) has looked at the value of web based communication channels for chronically ill patients to support their self-management and increase the effectiveness of interventions. Specifically it considers non-concurrent (‘asynchronous’) methods of communication between patient and clinician, such as email or discussion board (as opposed to concurrent communication such as phone consultation or video conferencing).
The aim of the study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behaviour, health outcomes, and patient satisfaction.
A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analysed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analysed by examining effects on health behaviour, health outcomes, and patient satisfaction.
The study found that patients’ knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies. Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients and for asthmatic patients Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes.
The full study can be read here.