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

Int J Environ Res Public Health. 2019 Oct 22;16(20):4047. doi: 10.3390/ijerph16204047.


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.

Keywords: digital health; health literacy; patient education; rehabilitation; telemedicine.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Biomedical Technology
  • Fractures, Bone / prevention & control
  • Fractures, Bone / rehabilitation*
  • Health Communication
  • Health Personnel
  • Humans
  • Randomized Controlled Trials as Topic
  • Telemedicine*