Telehealth: A new fix for an old problem – helping people with chronic conditions take better care of themselves

The Bottom Line

  • Chronic conditions like type 2 diabetes, and heart disease occur frequently among aging populations.
  • Telehealth is an effective way to promote communication between older adults and their health care providers.
  • This strategy can allow older adults to better manage their own health, minimizing the effect that their chronic condition has on their everyday life.

Technology has become a part of our everyday lives. In fact, you are probably reading this blog right now on your phone, tablet or computer. Unfortunately for some, chronic illness is also an everyday reality that comes with many new prescriptions and confusing rules to keep symptoms at bay.

A chronic condition is one that doesn’t go away with time, usually lasting longer than three months. Conditions such as heart disease, type 2 diabetes, respiratory disease, and arthritis fall into this category (1). Many people who have a chronic condition, have more than one, making them more challenging to manage (2;3). Older adults are at an increased risk for chronic conditions (3).

Chronic conditions are often “self-managed”. Self-management skills are daily activities that can help you take control of or lower the impact that a chronic condition has on your life (4). Some examples include taking your medications as instructed, improving your diet, or getting more exercise (5).

But for some, self-management is an overwhelming task. This is where technology may help (3;6;7;8;9).

“Telehealth” is emerging as a good way to improve a patient’s self-management skills. It uses communications technology – including audio, video and websites – to deliver healthcare services and health information to people near and far (10).

A chronic health condition can be a heavy burden, especially when it comes to managing your own care. Can telehealth lighten your load?


What the research tells us

Research shows that telehealth can support self-management among older adults with chronic conditions, in part by building capacity for improving self-care skills and self-monitoring behaviors (3;6;7;8;9).

For example, technology that improves long-distance communication between older adults and their health care providers helped patients with chronic conditions take their medications as directed and improve self-care. Patients were more knowledgeable about their health, and experienced a better overall quality of life (3). Additionally, when looking at respiratory disease, type 2 diabetes, and heart disease, telehealth led to a reduction in hospitalization rates (6), and improved blood sugar control (7;8) and weight and BMI (9), respectively. For conditions such as rheumatoid arthritis and an over-active bladder, web-based communication strategies (such as discussion boards and online surveys) were also effective at empowering patients to take better care of themselves (3).

Future research should evaluate the long-term effectiveness of telehealth, because some studies have shown that the benefits decrease over time. The impact of additional factors such as ethnicity and culture also warrants attention (3).

If you suffer from a chronic condition, cast your morbid thoughts aside – there are things you can do to self-manage it and improve your health. Embracing technology is one of them.


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References

  1. Bernell S, Howard SW. Use your words carefully: What is a chronic disease? Front Public Health. 2016; 4:159. doi: 10.3389/fpubh.2016.00159.
  2. National Council on Aging. Chronic disease management in seniors. [Internet] 2015. [cited January 2018] Available from https://www.ncoa.org/healthy-aging/chronic-disease/
  3. Guo Y, Albright D. The effectiveness of telehealth on self-management for older adults with a chronic condition: A comprehensive narrative review of the literature. J Telemed Telecare. 2017; 1: 1357633X17706285. doi: 10.1177/1357633X17706285. 
  4. Barlow J, Wright C, Sheasby J, et al. Self-management approaches for people with chronic conditions: A review. Patient Educ Couns. 2002; 48(2):177-187.
  5. Clark NM, Becker MH, Janz NK, et al. Self-management of chronic disease by older adults: A review and questions for research. J Aging Health. 1991; 3(1):3-27. https://doi.org/10.1177/089826439100300101.
  6. Cruz J, Brooks D, Marques A. Home telemonitoring effectiveness in COPD: A systematic review. Int J Clin Pract. 2014; 68(3):369-378. doi: 10.1111/ijcp.12345.
  7. Hou C, Carter B, Hewitt J, et al. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials. Diabetes Care. 2016; 39(11):2089-2095. 
  8. Cui M, Wu X, Mao J, et al. T2DM self-management via smartphone applications: A systematic review and meta-analysis. PLoS One. 2016; 11(11):e0166718. doi: 10.1371/journal.pone.0166718. 
  9. Widmer RJ, Collins NM, Collins CS, et al. Digital health interventions for the prevention of cardiovascular disease: A systematic review and meta-analysis. Mayo Clin Proc. 2015; 90(4):469-480. doi: 10.1016/j.mayocp.2014.12.026. 
  10. Picot J. Telemedicine and telehealth in Canada: Forty years of change in the use of information and communications technologies in a publicly administered health care system. Telemed J. 1998; 4(3):199-205.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.