Digital health interventions for patient engagement: A systematic umbrella review
Digital tools are increasingly integrated into patient engagement (PE) in chronic disease management, yet findings remain fragmented across populations, modalities, and outcome definitions. The aim of this umbrella review was to systematically review evidence on the effectiveness of Digital Health Interventions (DHIs) to enhance PE and related health outcomes. Six databases were searched for eligible studies published from inception to June 2025. Systematic reviews with meta-analyses of DHIs targeting engagement outcomes (e.g., self-management, adherence, activation) were included. Forty-two reviews (853 primary studies; ≈ 574,676 participants) met inclusion criteria, with most rated low-quality using AMSTAR-2. Meta-meta-analyses suggested DHIs could improve medication adherence (SMD = 0.65, 95% CI: 0.22, 1.08). Secondary outcomes also demonstrated potential for DHIs to improve quality of life (SMD = 0.26) and HbA1c (MD = -0.45%). Subgroup analyses indicated variation in effects across age groups and conditions for medication adherence and quality of life. Thus, digital health interventions may provide scalable, though moderate, improvements in patient engagement behaviours and selected clinical outcomes across diverse populations and conditions. Despite statistically significant pooled estimates for selected outcomes, due to the predominance of low-quality reviews, findings should be interpreted as exploratory evidence of effectiveness. Future implementation should be informed by higher-quality systematic reviews, longer-term primary studies, and additional evidence on patient activation and satisfaction.
Authors
- Afifa Tanweer (ORCID: https://orcid.org/0000-0002-0174-2941)
- Yankuba B. Manga (ORCID: https://orcid.org/0000-0002-8750-3721)
- Usman Iqbal (ORCID: https://orcid.org/0000-0002-0614-123X)
- Dina Nur Anggraini Ningrum (ORCID: https://orcid.org/0000-0002-8557-2862)
- Julie Redfern (ORCID: https://orcid.org/0000-0001-8707-5563)
- Leo Anthony Celi (ORCID: https://orcid.org/0000-0001-6712-6626)
- Ayesha Humayun (ORCID: https://orcid.org/0000-0001-7992-8765)
- Gulasekaran Rajaguru (ORCID: https://orcid.org/0000-0003-2816-1749)
- Mochammad Fadjar Wibowo (ORCID: https://orcid.org/0000-0002-1269-3081)
- Annisa Ristya Rahmanti (ORCID: https://orcid.org/0000-0001-9478-6267)
- Lutfan Lazuardi (ORCID: https://orcid.org/0000-0001-5146-8162)
- Dumisani Nkhoma (ORCID: https://orcid.org/0000-0002-8951-5072)
- Sharon M Mickan (ORCID: https://orcid.org/0000-0002-5690-1997)
- Max V. Moldovan (ORCID: https://orcid.org/0000-0001-9680-8474)
- Suleman Atique (ORCID: https://orcid.org/0000-0002-5149-0703)
- Hsuan-Chia Yang
- Yu-Chuan Jack Li (ORCID: https://orcid.org/0000-0001-6497-4232)
- Syed Measum Haider Bokhari
- Chih-Wei Huang
Institutions
- Bond University (AU)
- Oslo University Hospital (NO)
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- University of Lahore (PK)
- State University of Semarang (ID)
- Universitas Gadjah Mada (ID)
- University of Management and Technology (US)
- Gold Coast Hospital (AU)
- Centre Hospitalier Universitaire Vaudois (CH)
- Wan Fang Hospital (TW)
- Gold Coast Health (AU)
- Shaikh Zayed Postgraduate Medical Institute (PK)
- Artificial Intelligence in Medicine (Canada) (CA)
- Adelaide University (AU)
- Taipei Medical University (TW)
- The University of Adelaide (AU)
- Massachusetts Institute of Technology (US)
- University of Management and Technology (PK)
- University of Lausanne (CH)
- National Taipei University (TW)
Publication Details
- Journal
- PLOS Digital Health
- Published
- 2026-10-30
- DOI
- https://doi.org/10.1371/journal.pdig.0001785
- Primary Topic
- Mobile Health and mHealth Applications
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Health and Medical Research Council