Digital Health (Jun 2023)

Exploring the use of digital technology to deliver healthcare services with explicit consideration of health inequalities in UK settings: A scoping review

  • Albert Farre,
  • Mei Fang,
  • Beth Hannah,
  • Meiko Makita,
  • Alison McFadden,
  • Deborah Menezes,
  • Andrea Rodriguez,
  • Judith Sixsmith,
  • Nicola M Gray

DOI
https://doi.org/10.1177/20552076231185442
Journal volume & issue
Vol. 9

Abstract

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Objective To map and explore existing evidence on the use of digital technology to deliver healthcare services with explicit consideration of health inequalities in UK settings. Methods We searched six bibliographic databases, and the National Health Service (NHS) websites of each UK nation (England, Scotland, Wales, Northern Ireland). Restrictions were applied on publication date (2013–2021) and publication language (English). Records were independently screened against eligibility criteria by pairs of reviewers from the team. Articles reporting relevant qualitative and/or quantitative research were included. Data were synthesised narratively. Results Eleven articles, reporting data from nine interventions, were included. Articles reported findings from quantitative (n = 5), qualitative (n = 5), and mixed-methods (n = 1) studies. Study settings were mainly community based, with only one hospital based. Two interventions targeted service users, and seven interventions targeted healthcare providers. Two studies were explicitly and directly aimed at (and designed for) addressing health inequalities, with the remaining studies addressing them indirectly (e.g. study population can be classed as disadvantaged). Seven articles reported data on implementation outcomes (acceptability, appropriateness, and feasibility) and four articles reported data on effectiveness outcomes, with only one intervention demonstrating cost-effectiveness. Conclusions It is not yet clear if digital health interventions/services in the UK work for those most at risk of health inequalities. The current evidence base is significantly underdeveloped, and research/intervention efforts have been largely driven by healthcare provider/system needs, rather than those of service users. Digital health interventions can help address health inequalities, but a range of barriers persist, alongside a potential for exacerbation of health inequalities.