A HIFA member has kindly emailed to me the full text of this restricted-access paper (demonstrating that the ability to access free full text is inequitable – it depends on one’s contacts). Below are some key points from the full text:

1. A total of 19 studies met the selection criteria and were included in the systematic review. It was not clear where the studies were conducted. The focus was on patients recovering from heart surgery, such as corinary artery bypass graft and valve surgery.

2. Generally, the control group received a structured educational brochure, while most of the interventions comprised ‘a structured web-based patient education  intervention that consisted of pre-designed screens. This type of web-based education required the study participant to review each screen, in sequential order, prior to moving to the next educational screen. The content areas addressed throughout the structured web-based education were similar to those presented in the education brochure received by the control group study participants. … more than half (60%) of the websites contained information related to additional resources and references, 40% provided their study participants with access to an ask an expert chat forum, 30% created online discussion groups, and approximately 10% had an online skills workshop that could be accessed upon review of the education’.

3. ‘A statistically significant difference [in self care behaviour] between individuals who received the web-based intervention and those who received standard

patient education (i.e., structured educational brochure) in terms of number of self-care behaviors performed during post-discharge recovery is noted’ [see full paper for details, which vary according to study]

4. The findings suggest: ‘using an individualized web-based patient education intervention may be more effective than a booklet or standardized patient education website’ and ‘the most effective form of web-based patient education is one that is interactive and allows patients to navigate the online system on their own’.

Perhaps the most important conclusion (which is captured in the Abstract) is that ‘the most effective form of web-based patient education is one that is interactive and allows patients to navigate the online system on their own’. This suggests that the way in which content is developed and presented is critical. As we have discussed before on HIFA, the challenge of the coming decade is likely to shift from access to content. The development of reliable, appropriate and effective content (where possible open-access) and helping people to find it will be key to the realisation of healthcare information for all. It’s vital that global health funders recognise this and support it accordingly, both to sieze the opportunity and to mitigate the negative impact of commercial advertising (big pharma already spends 373 million US dollars per year worldwide on mobile phone advertising).

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Best wishes, Neil

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