Abstract：
BACKGROUND: Liver transplantation has become increasingly common as a last-resort treatment for end-stage liver diseases and liver cancer, with continually improving success rates and long-term survival rates. Nevertheless, liver transplant recipients face lifelong challenges in self-management, including immunosuppressant therapy, lifestyle adjustments, and navigating complex health care systems. eHealth technologies hold the potential to aid and optimize self-management outcomes, but their adoption has been slow in this population due to the complexity of post-liver transplant management.
OBJECTIVE: This study aims to examine the use of eHealth technologies in supporting self-management for liver transplant recipients and identify their benefits and challenges to suggest areas for further research.
METHODS: Following the Arksey and O\'Malley methodology for scoping reviews, we conducted a systematic search of 5 electronic databases: PubMed, CINAHL, Embase, PsycINFO, and Web of Science. We included studies that (1) examined or implemented eHealth-based self-management, (2) included liver transplant recipients aged ≥18 years, and (3) were published in a peer-reviewed journal. We excluded studies that (1) were case reports, conference abstracts, editorials, or letters; (2) did not focus on the posttransplantation phase; (3) did not focus on self-management; and (4) did not incorporate the concept of eHealth or used technology solely for data collection. The quality of the selected eHealth interventions was evaluated using (1) the Template for Intervention Description and Replication guidelines and checklist and (2) the 5 core self-management skills identified by Lorig and Holman.
RESULTS: Of 1461 articles, 15 (1.03%) studies were included in the final analysis. Our findings indicate that eHealth-based self-management strategies for adult liver transplant recipients primarily address lifestyle management, medication adherence, and remote monitoring, highlighting a notable gap in alcohol relapse interventions. The studies used diverse technologies, including mobile apps, videoconferencing, and telehealth platforms, but showed limited integration of decision-making or resource use skills essential for comprehensive self-management. The reviewed studies highlighted the potential of eHealth in enhancing individualized health care, but only a few included collaborative features such as 2-way communication or tailored goal setting. While adherence and feasibility were generally high in many interventions, their effectiveness varied due to diverse methodologies and outcome measures.
CONCLUSIONS: This scoping review maps the current literature on eHealth-based self-management support for liver transplant recipients, assessing its potential and challenges. Future studies should focus on developing predictive models and personalized eHealth interventions rooted in patient-generated data, incorporating digital human-to-human interactions to effectively address the complex needs of liver transplant recipients. This review emphasizes the need for future eHealth self-management research to address the digital divide, especially with the aging liver transplant recipient population, and ensure more inclusive studies across diverse ethnicities and regions.
OBJECTIVE: This study aims to examine the use of eHealth technologies in supporting self-management for liver transplant recipients and identify their benefits and challenges to suggest areas for further research.
METHODS: Following the Arksey and O\'Malley methodology for scoping reviews, we conducted a systematic search of 5 electronic databases: PubMed, CINAHL, Embase, PsycINFO, and Web of Science. We included studies that (1) examined or implemented eHealth-based self-management, (2) included liver transplant recipients aged ≥18 years, and (3) were published in a peer-reviewed journal. We excluded studies that (1) were case reports, conference abstracts, editorials, or letters; (2) did not focus on the posttransplantation phase; (3) did not focus on self-management; and (4) did not incorporate the concept of eHealth or used technology solely for data collection. The quality of the selected eHealth interventions was evaluated using (1) the Template for Intervention Description and Replication guidelines and checklist and (2) the 5 core self-management skills identified by Lorig and Holman.
RESULTS: Of 1461 articles, 15 (1.03%) studies were included in the final analysis. Our findings indicate that eHealth-based self-management strategies for adult liver transplant recipients primarily address lifestyle management, medication adherence, and remote monitoring, highlighting a notable gap in alcohol relapse interventions. The studies used diverse technologies, including mobile apps, videoconferencing, and telehealth platforms, but showed limited integration of decision-making or resource use skills essential for comprehensive self-management. The reviewed studies highlighted the potential of eHealth in enhancing individualized health care, but only a few included collaborative features such as 2-way communication or tailored goal setting. While adherence and feasibility were generally high in many interventions, their effectiveness varied due to diverse methodologies and outcome measures.
CONCLUSIONS: This scoping review maps the current literature on eHealth-based self-management support for liver transplant recipients, assessing its potential and challenges. Future studies should focus on developing predictive models and personalized eHealth interventions rooted in patient-generated data, incorporating digital human-to-human interactions to effectively address the complex needs of liver transplant recipients. This review emphasizes the need for future eHealth self-management research to address the digital divide, especially with the aging liver transplant recipient population, and ensure more inclusive studies across diverse ethnicities and regions.
摘要：
背景：肝移植作为终末期肝病和肝癌的最后手段治疗越来越普遍，不断提高成功率和长期生存率。然而，肝移植受者在自我管理方面面临终身挑战，包括免疫抑制剂治疗,生活方式的调整，和导航复杂的医疗保健系统。电子健康技术具有帮助和优化自我管理结果的潜力，但是由于肝移植后管理的复杂性，在该人群中采用它们的速度很慢。
目的：本研究旨在研究电子健康技术在支持肝移植受者自我管理中的应用，并确定其益处和挑战，为进一步研究提出建议。
方法：遵循Arksey和O\'Malley范围审查方法，我们对5个电子数据库进行了系统的搜索：PubMed，CINAHL,Embase,PsycINFO,和WebofScience。我们纳入了(1)检查或实施基于电子健康的自我管理的研究，（2）包括年龄≥18岁的肝移植受者，和（3）发表在同行评审的期刊上。我们排除了（1）是病例报告的研究，会议摘要，社论,（2）没有关注移植后阶段；（3）没有关注自我管理；（4）没有纳入eHealth的概念或仅用于数据收集的技术。使用（1）干预描述和复制指南模板和清单以及（2）Lorig和Holman确定的5种核心自我管理技能来评估选定的电子健康干预措施的质量。
结果：在1461篇文章中，最终分析中包括15项（1.03%）研究。我们的研究结果表明，基于电子健康的成人肝移植受者自我管理策略主要解决生活方式管理，药物依从性,和远程监控，突出了酒精复发干预方面的明显差距。这些研究使用了不同的技术，包括移动应用程序，视频会议,和远程医疗平台，但显示决策或资源使用技能的整合有限，这对于全面的自我管理至关重要。审查的研究强调了电子健康在加强个性化医疗保健方面的潜力，但只有少数包括协作功能，如双向沟通或量身定制的目标设置。虽然许多干预措施的依从性和可行性普遍较高，由于方法和结果衡量标准不同，它们的有效性也不同。
结论：本范围综述绘制了目前关于肝移植受者基于电子健康的自我管理支持的文献，评估其潜力和挑战。未来的研究应侧重于开发基于患者生成数据的预测模型和个性化的电子健康干预措施。结合数字人与人之间的互动，以有效地满足肝移植受者的复杂需求。这篇综述强调了未来电子健康自我管理研究解决数字鸿沟的必要性，特别是随着肝移植受者群体的老龄化，并确保跨不同种族和地区进行更具包容性的研究。
目的：本研究旨在研究电子健康技术在支持肝移植受者自我管理中的应用，并确定其益处和挑战，为进一步研究提出建议。
方法：遵循Arksey和O\'Malley范围审查方法，我们对5个电子数据库进行了系统的搜索：PubMed，CINAHL,Embase,PsycINFO,和WebofScience。我们纳入了(1)检查或实施基于电子健康的自我管理的研究，（2）包括年龄≥18岁的肝移植受者，和（3）发表在同行评审的期刊上。我们排除了（1）是病例报告的研究，会议摘要，社论,（2）没有关注移植后阶段；（3）没有关注自我管理；（4）没有纳入eHealth的概念或仅用于数据收集的技术。使用（1）干预描述和复制指南模板和清单以及（2）Lorig和Holman确定的5种核心自我管理技能来评估选定的电子健康干预措施的质量。
结果：在1461篇文章中，最终分析中包括15项（1.03%）研究。我们的研究结果表明，基于电子健康的成人肝移植受者自我管理策略主要解决生活方式管理，药物依从性,和远程监控，突出了酒精复发干预方面的明显差距。这些研究使用了不同的技术，包括移动应用程序，视频会议,和远程医疗平台，但显示决策或资源使用技能的整合有限，这对于全面的自我管理至关重要。审查的研究强调了电子健康在加强个性化医疗保健方面的潜力，但只有少数包括协作功能，如双向沟通或量身定制的目标设置。虽然许多干预措施的依从性和可行性普遍较高，由于方法和结果衡量标准不同，它们的有效性也不同。
结论：本范围综述绘制了目前关于肝移植受者基于电子健康的自我管理支持的文献，评估其潜力和挑战。未来的研究应侧重于开发基于患者生成数据的预测模型和个性化的电子健康干预措施。结合数字人与人之间的互动，以有效地满足肝移植受者的复杂需求。这篇综述强调了未来电子健康自我管理研究解决数字鸿沟的必要性，特别是随着肝移植受者群体的老龄化，并确保跨不同种族和地区进行更具包容性的研究。
