Utilising Digital Health Technology to Support Patient-Healthcare Provider Communication in Fragility Fracture Recovery: Systematic Review and Meta-Analysis.

Lalit Yadav,Anita Taylor,Tiffany Gill,Unyime Jasper,Renuka Visvanathan,Ayantika Haldar,Mellick Chehade

doi:10.3390/ijerph16204047

Abstract

The objective of this review is to evaluate the effectiveness of digital health supported targeted patient communication versus usual provision of health information, on the recovery of fragility fractures. The review considered studies including older people, aged 50 and above, with a fragility fracture. The primary outcome was prevention of secondary fractures by diagnosis and treatment of osteoporosis, and its adherence. This review considered both experimental and quasi-experimental study designs. A comprehensive search strategy was built to identify key terms including Medical subject headings (MeSH) and applied to the multiple electronic databases. An intention to treat analysis was applied to those studies included in the meta-analysis and odds ratio was calculated with random effects. Altogether, 15 studies were considered in the final stage for this systematic review. Out of these, 10 studies were Randomised controlled trials (RCT) and five were quasi experimental studies, published between the years 2003 and 2016 with a total of 5037 participants. Five Randomised control trails were included in the meta-analysis suggesting that digital health supported interventions were overall, twice as effective when compared with the usual standard care (OR 2.13, 95% CI 1.30–3.48), despite the population sample not being homogeneous. Findings from the remaining studies were narratively interpreted.

Highlights

IntroductionA low energy trauma, such as a fall from a standing height or less, can result in a fracture
In older people, a low energy trauma, such as a fall from a standing height or less, can result in a fracture
42 were considered for full text review, from which 15 studies were considered for this systematic review

Summary

Introduction

A low energy trauma, such as a fall from a standing height or less, can result in a fracture. This is known as a “fragility fracture” and is usually due to osteoporosis with its associated reduced bone density [1]. One of the most devastating fragility fractures is the hip fracture. Due to the significant increase in ageing and life expectancy globally, it is estimated that the annual number of fragility hip fractures is likely to reach 6.3 million by 2050. Twenty percent of hip fractures can be. Res. Public Health 2019, 16, 4047; doi:10.3390/ijerph16204047 www.mdpi.com/journal/ijerph

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