University of Oulu

Mikkonen, K., Yamakawa, M., Tomietto, M., Tuomikoski, A-M, Utsumi, M., Jarva, E., Kääriäinen, M., & Oikarinen, A. (2023). Randomised controlled trials addressing how the clinical application of information and communication technology impacts the quality of patient care—A systematic review and meta-analysis. Journal of Clinical Nursing, 32, 3295–3314.

Randomised controlled trials addressing how the clinical application of information and communication technology impacts the quality of patient care : a systematic review and meta-analysis

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Author: Mikkonen, Kristina1,2,3; Yamakawa, Miyae4; Tomietto, Marco5,6;
Organizations: 1Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
2The Finnish Centre for Evidence-Based Health Care: A JOANNA Briggs Institute Centre of Excellence, Helsinki, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Asakayama General Hospital, Osaka, Japan
5Department of Nursing, Midwifery and Healthcare, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
6Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
7Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.1 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-08-30


Background: The number of people with chronic and long-term conditions has increased during recent decades; this has been addressed by leveraging information and communication technology (ICT) to develop new self-care solutions. However, many of the developed technological solutions have not been tested in terms of impact(s) on patients’ quality of care.

Objectives: This systematic review aimed to identify the current best evidence on the types of interventions that have been developed to improve the quality of patient care through the clinical application of ICT in primary, tertiary or home care.

Design: A systematic review, including a meta-analysis, was conducted according to the JBI Manual for Evidence Synthesis guidelines.

Data sources: Relevant data were identified from four electronic databases: CINAHL, PUBMED, SCOPUS and MEDIC.

Review methods: The eligibility criteria were formatted according to PICOS inclusion and exclusion criteria. At least two researchers performed the screening process separately, after which they agreed upon the results. The Cochrane Risk of Bias Assessment and JBI Critical Appraisal tool for randomised controlled studies (RCTs) were used to assess research quality. Data were extracted, and a meta-analysis was performed if the research met quantitative requirements.

Results: Of the 528 initially identified studies, 11 studies were chosen for final data synthesis. All of the interventions integrated ICT solutions into patient care to improve the quality of care. Patients across all of the RCTs were educated through direct training, the provision of information relevant to their disease or one-to-one educational coaching. The interventions included various interactions, e.g. nurse expert visits and support, and support provided by peers, groups or family members. These interactions occurred through face-to-face coaching, virtual human coaching or virtual coaching that relied on an algorithm. The performed meta-analysis included 6 of the 11 identified studies. The overall effect was nonsignificant, with three studies demonstrating a significant postintervention effect on patients’ quality of care and quality of life and three studies a nonsignificant effect.

Conclusions: The presented results suggest that ICT-based care should be developed in collaboration with nurses and other health care professionals, involve patients in decision-making and combine ICT solutions with human interaction and coaching. ICT education was found to be essential to the success of an intervention.

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Series: Journal of clinical nursing
ISSN: 0962-1067
ISSN-E: 1365-2702
ISSN-L: 0962-1067
Volume: 32
Issue: 13-14
Pages: 3295 - 3314
DOI: 10.1111/jocn.16448
Type of Publication: A2 Review article in a scientific journal
Field of Science: 316 Nursing
Copyright information: © 2022 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.