Abstract
BackgroundThe communication relationship between parents of children or young people with health conditions and health professionals is an important part of treatment, but it is unclear how far the use of digital clinical communication tools may affect this relationship.ObjectiveThe objective of our study was to describe, assess the feasibility of, and explore the impact of digital clinical communication between families or caregivers and health professionals.MethodsWe searched the literature using 5 electronic databases. We considered all types of study design published in the English language from January 2009 to August 2015. The population of interest included families and caregivers of children and young people aged less than 26 years with any type of health condition. The intervention was any technology permitting 2-way communication.ResultsWe included 31 articles. The main designs were randomized controlled trials (RCTs; n=10), cross-sectional studies (n=9), pre- and postintervention uncontrolled (pre/post) studies (n=7), and qualitative interview studies (n=2); 6 had mixed-methods designs. In the majority of cases, we considered the quality rating to be fair. Many different types of health condition were represented. A breadth of digital communication tools were included: videoconferencing or videoconsultation (n=14), and Web messaging or emails (n=12). Health care professionals were mainly therapists or cognitive behavioral therapists (n=10), physicians (n=8), and nurses (n=6). Studies were very heterogeneous in terms of outcomes. Interventions were mainly evaluated using satisfaction or acceptance, or outcomes relating to feasibility. Clinical outcomes were rarely used. The RCTs showed that digital clinical communication had no impact in comparison with standard care. Uncontrolled pre/post studies showed good rates of satisfaction or acceptance. Some economic studies suggested that digital clinical communication may save costs.ConclusionsThis rapid review showed an emerging body of literature on the use of digital clinical communication to improve families’ and caregivers’ involvement in the health management of children or young people. Further research with appropriate study designs and longer-term outcome measures should be encouraged.Trial RegistrationPROSPERO CRD42016035467; http://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD 42016 035467(Archived by WebCite at http://www.webcitation.org/6vpgZU1FU)
Highlights
MethodsDigital clinical communication can be defined as a means of communication between a clinician and a person, when the clinician or the person is mobile when sending or receiving the communication, in a 2-way, synchronous or asynchronous manner, and for clinical care purposes only [1]
Parental involvement and parent-health professional relationships are an important part of the treatment journey of children and young people with health conditions, but it is unclear what impact digital communication has on these relationships, as young people transition into using adult services
Digital communication with health care providers may be used by families involved in the management of health conditions in much younger pediatric populations, where parents are fully acting as communicator with health services [10,11]
Summary
Digital clinical communication can be defined as a means of communication between a clinician and a person, when the clinician or the person (or both) is (or could be) mobile when sending or receiving the communication, in a 2-way, synchronous or asynchronous manner, and for clinical care purposes only [1]. Our objectives were to describe existing digital communication use by health professionals with families or caregivers of children or young persons with short- or long-term conditions, to assess the feasibility of using these technologies, and to explore their impact on (1) family and caregivers’ outcomes, (2) children and young people’s outcomes, (3) health professionals’ outcomes, and (4) health service delivery and health economics outcomes. For pre- and postintervention uncontrolled (pre/post) studies, cross-sectional and observational studies, and non-RCTs, we assessed study quality using checklists published by the US National Institutes of Health [17] We used these checklists because, in the context of a rapid review, these provide a useful way to assess several different study designs consistently and quickly.
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