Effectiveness of interactive digital health services in non-communicable diseases: An umbrella review and evidence synthesis from 26 meta-analyses

Int J Nurs Stud. 2025 Nov 5;174:105277. doi: 10.1016/j.ijnurstu.2025.105277. Online ahead of print.

ABSTRACT

BACKGROUND: New digital health services are continuously developed, implemented, tested, and refined to meet diverse health and system needs. With the rise in non-communicable diseases, these services are increasingly integrated into care processes. However, the effectiveness of digital health services varies across time and settings, highlighting the need to evaluate their effectiveness longitudinally and in specific settings.

OBJECTIVE: To synthesize current evidence from meta-analyses on the effectiveness of digital health services in non-communicable diseases.

DESIGN: Umbrella review.

DATA SOURCES: A search was conducted in Jun 2025 using Cochrane, Ovid Medline, Scopus, and Web of Science databases.

REVIEW METHODS: We included only peer-reviewed meta-analyses that synthetized RCTs that compared digital health services with usual care on outcomes in non-communicable diseases. Screening, data extraction, and risk of bias assessment were carried out independently by two researchers. Additionally, the strength of evidence was assessed.

RESULTS: This umbrella review analyses 26 meta-analyses to evaluate the effectiveness of digital health services in 12 non-communicable diseases. Most reviews indicate non-significant difference between digital health services and usual care in the clinical outcomes. Digital health services were associated with better clinical outcomes in type 2 diabetes, hypertension and heart failure. Digital health services were also associated with higher patient satisfaction. The heterogeneity of outcome measures limited possibilities in meta-analysis. Convincing evidence for improved outcomes was found in 3.75 %, highly suggestive evidence in 7.5 %, suggestive in 5.6 %, and weak evidence in 23.75 % of the reviews, respectively.

CONCLUSIONS: Digital health services are generally as effective as usual care in managing non-communicable diseases, while in specific patient groups they can yield improved clinical outcomes and, overall, higher patient satisfaction. This underscores the need for cost-effectiveness studies to identify services that deliver comparable outcomes at reduced costs. In addition, more high-quality research with standardized outcome measures is needed, as evidence on digital health services involving patient-professional interaction remains non-significant.

PMID:41270451 | DOI:10.1016/j.ijnurstu.2025.105277