Cystic Fibrosis and Digital Technology: A Systematic Review

Digital technology has made important inroads to advance the self-management and treatment of cystic fibrosis (CF) symptoms. To date, no integrative, comprehensive, systematic review of digital technology and CF has included the application of digital technology for mental health. The purpose of the current study was to complete an up-to-date systematic review of digital technology interventions for CF across symptom monitoring, treatment adherence, airway clearance, nutrition, exercise, and mental health.

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles reporting a quantitative study examining technology-based interventions for CF were included. Studies were excluded if they did not meet this criterion or if they were not written in English. PsycINFO, MEDLINE, EMBASE, and CINAHL databases were searched. Search terms included technology, CF, symptom monitoring, treatment adherence, quality of life, nutrition, exercise, and mental health.

Thirty-four studies were included in the review. Results demonstrated variable types of digital technologies, most predominantly applied to exercise. Inconsistencies were observed in terms of the effectiveness or efficacy of digital technology to address study outcomes across many application areas. Most consistent findings were found for the efficacy of digital technology applications for symptom monitoring (ie, improving early detection or prediction of pulmonary exacerbation), treatment adherence (ie, improvements in medication adherence, and nebulizer use), and mental health (ie, reductions in depression and anxiety).

Digital technology applications offer the potential for improved CF care; however, many of the existing studies show limited evidence for their effectiveness. Well-designed, methodologically robust studies are required to fully understand the utility of digital technology in CF care.