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Background Digital health technology has the potential to improve the management of chronic diseases in older adults. However, we need to understand the barriers and facilitators to the use of digital technology in this group. The current study aimed to update and extend a previous systematic review on the topic.
Aim Our aim was to identify barriers and facilitators to digital adoption by older adults, compare differences between urban & rural populations and explore the role of co-design.
Method A systematic literature was conducted of four databases for relevant studies published in English since the previous systematic review was undertaken. A grey literature search was also conducted.
Results Co-design was identified as a facilitator, but this only occurred in 7 out of 29 studies. Four out of 29 studies reported on rurality; however, they did not provide a definition of rurality. The PROGRESS-Plus framework helped us identify patient information reported in the studies and consider equity in the review. This highlighted the disparity in reporting between the studies and lack of standardisation.
Conclusion A lack of standardisation and agreed definition of rurality makes it difficult to compare rural and urban findings. Healthcare professions play a key role. Barriers include overworked clinicians; lack of training; funding; digital skills and workflow integration. Facilitators include enthusiasm, interest in digital data and positive feedback. Patients are more likely to adopt digital tools if endorsed by healthcare providers. Fear of replacing in-person care is a concern, especially in areas where GP-to-patient ratios are better, and satisfaction is high.
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British Journal of General Practice
