Accessibility settings

Published on in Vol 15 (2026)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/60542, first published .
Information and Communication Technologies for Chronic Disease Self-Management in Adults Aged 65 Years and Older: Scoping Review

Information and Communication Technologies for Chronic Disease Self-Management in Adults Aged 65 Years and Older: Scoping Review

Information and Communication Technologies for Chronic Disease Self-Management in Adults Aged 65 Years and Older: Scoping Review

Authors of this article:

Paul Murdock1 Author Orcid Image ;   Yiyi Wu2 Author Orcid Image ;   Charles R Senteio2 Author Orcid Image

1Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, United States

2Rutgers University School of Communication and Information, New Brunswick, NJ, United States

Corresponding Author:

Paul Murdock, MD, MS


Background: The increasing number of older adults living with chronic conditions has led to rapid growth in information and communication technologies (ICTs) designed to support chronic disease self-management. Although many technologies target behaviors such as medication adherence, physical activity, dietary management, and follow-up care, the breadth, characteristics, and design considerations of these tools for adults aged 65 years and older have not been comprehensively reported.

Objective: This scoping review aims to systematically map the existing literature describing ICTs developed to support chronic disease self-management among adults aged 65 years and older. Specifically, the review seeks to (1) identify the types of ICTs available; (2) characterize the self-management behaviors they target; and (3) examine the extent of older adults’ involvement in the design, adaptation, or evaluation of these technologies.

Methods: This review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Seven databases (PubMed, CINAHL, Web of Science, Cochrane Library, Compendex, IEEE Xplore, and Computers & Applied Sciences Complete) were searched, with all searches completed on December 15, 2024. Inclusion criteria were peer-reviewed studies published in English between 2007 and 2025 that (1) included adults aged ≥65 years; (2) addressed one or more chronic diseases; and (3) evaluated, described, or tested an ICT intended to support at least 1 chronic disease self-management behavior. Two reviewers independently screened all titles and abstracts and full texts; disagreements were resolved by a third reviewer. Data were charted using a standardized extraction template and synthesized narratively by technology type and self-management domain.

Results: Nineteen studies met the inclusion criteria. Technologies were grouped into 4 broad categories: mobile apps, online platforms, wearable or sensor-based tools, and smart home or device-integrated systems. Physical activity and medication management were the most targeted self-management behaviors, whereas follow-up appointment adherence and dietary behaviors were less frequently addressed. Only a small number of studies explicitly involved older adults in the design or development process, and such involvement was often limited to usability testing rather than participatory co-design.

Conclusions: The current evidence base is fragmented, with substantial variability in technology types, targeted behaviors, and reported outcomes. Significant gaps remain regarding the participatory design of ICTs with older adults and the development of technologies that address multiple self-management needs simultaneously. Future ICT development should intentionally incorporate older adults and caregivers throughout the design cycle and expand beyond single-behavior interventions to reflect the multimorbidity common in this population.

Interact J Med Res 2026;15:e60542

doi:10.2196/60542

Keywords



Most population projections estimate that by 2030, 1 in 6 people worldwide will be aged 60 years or older [1], compared with 1 in 10 at present [2]. The older adult population is expected to grow and eventually double by 2050, reaching 2.1 billion persons worldwide [1]. According to the US Centers for Disease Control and Prevention, 6 in 10 adults in the United States are living with 1 or more of the “big five” chronic conditions: diabetes mellitus, cardiovascular disease, chronic respiratory disease, cancer, and stroke [3]. Older adults are at increased risk of having chronic conditions; two-thirds of Medicare beneficiaries have 2 or more chronic conditions [3]. This shifting demographic and the prevalence of chronic conditions result in an expanding number of older adults living with chronic conditions.

For individuals living with chronic diseases, effective self-management, wherein patients take an active role in their own care, is essential for improving physical health, emotional well-being, and overall quality of life [4]. Self-management typically involves patients consistently engaging in healthy lifestyle behaviors, including maintaining a balanced diet, participating in regular physical activity, adhering to prescribed medications, and attending follow-up medical appointments [5].

Rapid advancements in technology (ie, smartphones and applications), connectivity (ie, mobile broadband availability), and commercial potential have resulted in an explosion of numerous information and communications technology (ICT) tools designed to support chronic disease self-management behaviors [6-8]. For older adults in particular, technologies designed to support health care and chronic disease management are classified into four general areas, which are based upon location of use and platform: (1) mobile-based apps, (2) smart home–based technologies, (3) online-based technologies, and (4) personalized application-based technologies [9]. Mobile-based apps, typically accessed via smartphones and tablets, are widely used to support remote medical services and personalized care. Among these, mobile health and telehealth platforms are the most prevalent. Smart home technologies, which incorporate ICT-enabled tools within the home, such as digital reminders for medical appointments, are increasingly recognized for their role in chronic disease management. Online-based technologies mainly refer to web-based services, including access to podcasts, disease-specific forums, health care providers and product reviews, and other health-related content, all of which support informed decision-making and continuous engagement with care. Personalized application-based technologies refer to a wide range of assistive devices that are programmed to improve care outcomes for older adults. Examples include intelligent devices that monitor vital signs such as blood pressure.

However, using ICTs to support chronic disease self-management among older adults presents significant challenges due to age-related barriers to technology use and engagement [10]. These barriers include generally lower levels of digital literacy and skills; increased concerns about privacy; and physical or cognitive limitations such as impaired vision, hearing loss, and memory decline [11-14]. As a result, older adults often depend on caregivers to effectively use health technologies [15]. In response, the literature has consistently emphasized the need for more accessible and inclusive design, particularly for ICTs aimed at this population [16]. A widely endorsed approach is to involve both older adults and their caregivers in the design process [17,18]. This co-design strategy has been shown to enhance usability, increase patient satisfaction, improve disease management, boost health literacy, and reduce health care costs [18].

Despite substantial expansion of ICTs for chronic disease management, our search found that the literature specifically focused on adults aged 65 years and older remains fragmented and inconsistent. Prior reviews often examine younger populations, focus narrowly on single diseases (eg, diabetes), or aggregate technologies without distinguishing specific self-management behaviors. To date, no comprehensive review has mapped the breadth of ICTs supporting self-management behaviors uniquely for adults aged 65 years and older.

A scoping review is methodologically suited to (1) map broad and diverse bodies of literature, (2) clarify key concepts, (3) identify types of evidence, and (4) highlight gaps rather than evaluate intervention effectiveness or pool outcomes. Given the wide variation in study designs, technologies, and outcomes and the exploratory nature of the research questions, a scoping review is justified and aligns with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidance.

Guided by this rationale, this scoping review aims to address the following research questions:

  1. What types of ICTs have been developed to support chronic disease self-management among adults aged 65 years and older?
  2. Which self-management behaviors (eg, medication adherence, physical activity, dietary management, and follow-up care) are targeted by these technologies?
  3. To what extent are older adults involved in the design, adaptation, or evaluation of these technologies?

Protocol and Registration

This review followed the PRISMA-ScR guidelines. The protocol was not registered.

Eligibility Criteria

Consistent with scoping review methodology, eligibility criteria were developed to capture the breadth of literature describing ICTs that support chronic disease self-management among adults aged 65 years and older, rather than to evaluate intervention effectiveness.

The inclusion and exclusion criteria are summarized in Textbox 1.

Textbox 1. Inclusion and exclusion criteria.

Inclusion criteria

  • Population—adults aged 65 years or older managing 1 or more chronic diseases
  • Concept—information and communication technologies (ICTs) designed to support at least 1 chronic disease self-management behavior, including (but not limited to) medication adherence, physical activity, diet, or follow-up appointment attendance
  • Context—any setting (eg, home, community, and clinical)
  • Types of sources: peer-reviewed empirical studies (qualitative, quantitative, mixed methods, feasibility or pilot studies, observational studies, or trials) published in English between 2007 and 2025

Exclusion criteria

  • Interventions targeting only health care providers
  • Nondigital or nonpersonalized technologies
  • Studies not focused on chronic disease self-management
  • Reviews, editorials, protocols, conference abstracts, or dissertations

A pilot screening phase was conducted during the initial article selection, in which similar articles from target journals were reviewed to refine the scope and thematic alignment of this review. This process guided database selection and search strategy refinement but was not part of the formal eligibility criteria. Because the goal of a scoping review is to map existing evidence rather than restrict it based on study design or comparator groups, no comparator was required or used as part of the eligibility criteria.

Information Sources

A comprehensive search was conducted in 7 databases selected in collaboration with a health sciences librarian: PubMed, CINAHL, Web of Science, Cochrane Library, Compendex, IEEE Xplore, and Computers & Applied Sciences Complete. All searches were completed on December 15, 2024. Reference lists of included studies were hand searched for additional relevant articles.

Search Strategy

Search terms were developed to reflect the review’s core aims: older adults, digital health technologies, and chronic disease self-management. Terms were adapted for each database using controlled vocabulary (eg, Medical Subject Headings [MeSH]) and keywords. Detailed search strings are included in Multimedia Appendix 1.

Study Selection

Titles and abstracts were independently screened by 2 reviewers (PM and CRS). Rayyan, an internet-based software package, was used to facilitate article screening [19]. The 2 authors independently completed the title and abstract screening and full-text screening. Full texts of potentially eligible studies were assessed using the defined inclusion and exclusion criteria. Disagreements were resolved through consensus with the third author (YW). A PRISMA-ScR flow diagram was used to outline the study identification and selection process.

Data Collection Process

In accordance with scoping review methodology, a standardized data charting form was developed and iteratively refined. Two reviewers (PM and CRS) independently extracted data from the included studies using a standardized data extraction form. Extracted data included study characteristics (author, year, and country), population demographics, technology description, targeted chronic diseases, self-management domain, outcomes related to technology use and acceptance, and reported effectiveness. The third reviewer (YW) resolved disagreements.

Data Items

Key data items included the following:

  • Author, year, and country
  • Study design
  • Participant age and health status
  • Type and functionality of technology
  • Chronic diseases addressed
  • Self-management behaviors targeted
  • Setting (home based, clinical, and other)
  • Extent and type of older adult involvement in design or evaluation
  • Reported outcomes (clinical, behavioral, or usability related)

Data charting was iterative; reviewers updated the form as familiarity with the literature increased, in accordance with best practices for scoping reviews.

Synthesis of Results

Consistent with PRISMA-ScR, no risk of bias or formal quality assessment was conducted, as the goal was to describe the extent and nature of existing evidence rather than to evaluate or compare intervention effectiveness.

Because of substantial heterogeneity in study designs, outcomes, technologies, and measurement approaches, meta-analysis was neither planned nor appropriate. This aligns with the purpose of a scoping review.

Narrative and Thematic Synthesis

A descriptive, narrative synthesis was conducted. Studies were grouped according to the following categories:

  • Technology type (mobile apps, web-based platforms, wearable or sensor technologies, and smart home systems)
  • Targeted self-management behaviors
  • Chronic disease or health focus
  • Degree of older adult involvement in design or testing

To identify key themes across studies, we used a structured thematic analysis process. First, during initial coding, 2 reviewers independently reviewed charted data and coded recurring concepts related to technology use, usability, self-management support, and design involvement. Second, in code consolidation, codes were compared, merged, and refined through discussion. Third, we used theme development to group codes into preliminary categories and iteratively refined them to generate overarching themes reflecting patterns across studies. Fourth, in a final synthesis, themes were summarized and integrated into the narrative results. This analytic process enabled identification of major trends, gaps, and characteristics of the literature.

Effect Measures

Because this is a scoping review, no standardized effect measures were calculated. When available, quantitative outcomes (eg, percentages, use statistics, and self-reported behavior changes) were summarized descriptively based on the information reported in each study.


Study Selection

The database search identified 897 records. After deduplication, 815 (90.9%) titles and abstracts were screened. Following full-text review, 19 (2.1%) studies met the inclusion criteria. The study identification and selection process is summarized in Figure 1 (the PRISMA-ScR flow diagram).

Figure 1. PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) flow diagram illustrating the identification, screening, eligibility assessment, and inclusion of sources of evidence.

Characteristics of Included Studies

The 19 included studies were published between 2007 and 2025, with the majority (n=18, 94.7%) published after 2012. Studies were conducted across multiple disciplines, including rehabilitation, geriatrics, computer engineering, nursing, and digital health.

Sample sizes varied substantially, ranging from 10 to 803 participants, with most studies enrolling fewer than 120 participants. All studies included older adults aged 65 years and older, although several recruited broader adult populations and reported subgroup data for older adults.

Technologies described in the included studies (n=19) encompassed 4 primary categories: mobile apps and tablets (n=9, 47.4%), web-based platforms (n=5, 26.3%), wearable or sensor-based technologies (n=3, 15.8%), and smart home or device-integrated systems (n=2, 10.5%).

Self-management behaviors targeted most frequently included physical activity (n=11, 57.9%) and medication management (n=10, 52.6%). Dietary behavior (n=7, 36.8%) and follow-up appointment support (n=3, 15.8%) were less commonly addressed.

A detailed summary of charted study characteristics is provided in Table 1.

Table 1. Charted characteristics of included studies (n=19).
StudyTechnology typeSelf-Management focusAge (years)Sample size, nNotes (major study features)
Nischelwitzer [20] 2007Mobile medical appPhysiological tracking36‐8415Early mobile prototype; pilot feasibility
Ali et al [21] 2012Touchscreen platformNutritional education60‐7631Education-focused dietary interface
Ammann et al [22] 2012Web platformPersonalized physical activity19‐89803Large sample; tailored content
Hess et al [23] 2012SMS text messagingActivity and dietary support40‐6947Combined prompting system
Reeder et al [24] 2013Digital pill dispenserMedication managementAverage 8096Device-integrated system
Jiménez-Fernández et al [25] 2013Wireless sensorsPhysiological trackingAverage 6522Wearable monitoring
Ellis et al [26] 2013Pedometer and computerPhysical activityAverage 65.620Exercise-focused
Mira et al [27] 2014Tablet appMedication management≥6599Self-medication support
Dasgupta et al [28] 2016Tablet appActivity and medication managementAverage 66.816Multifunction platform
Costa et al [29] 2017Smart TV systemSocial and health services≥6562TV-based interface
Georgsson and Staggers [30] 2017SMS serviceFollow-up, activity, and medicationMajority aged 60‐6910Multibehavior SMS support
Yan and Or [31] 2017Tablet with blood pressure and glucose metersPhysiological trackingAverage 69.9119Integrated monitoring
Pariser et al [32] 2019TelemedicineAccess to resourcesAverage 6676Virtual care
Lang et al [33] 2022TabletPhysiological tracking≥65116Remote monitoring
Nambisan et al [34] 2022Mobile appPhysical activity and diet60‐8020Behavior logging
Traviss-Turner et al [35] 2024Web programDietary behavior25 to >6522Binge eating reduction
Shi et al [36] 2024Web programExercise and diet monitoringAverage 67.264Lifestyle modification
Valdeverona et al [37] 2024SMS textingDiet, exercise, and medications37‐8238Multidomain support
Spinean et al [38] 2025Mobile appPhysical activity and diet18 to >65147Large mixed-age sample

Mapping of Self-Management Behaviors

To describe the scope of self-management behaviors addressed by ICTs, the 19 included studies were categorized according to the primary behavior targeted.

Physical activity was addressed in 11 (57.9%) studies. These studies evaluated pedometers, activity monitoring mobile apps, wearable sensors, or web-based activity programs. Approaches included real-time step tracking, motivational prompts, and personalized exercise recommendations.

Medication management was targeted in 10 (52.6%) studies. Technologies included digital pillboxes, reminder systems, medication self-management apps, and SMS text messaging medication prompts. Most outcomes were descriptive, reporting perceived usefulness, adherence trends, or frequency of system use.

Dietary behavior was addressed in 7 (36.8%) studies. These ICTs focused on dietary logging, nutritional education through tablet or TV interfaces, and monitoring of self-reported dietary behaviors. Few studies provided objective dietary outcomes; most reported usability, satisfaction, or behavioral intentions.

Follow-up appointment support was addressed in 3 (15.8%) studies. Appointment reminders were delivered through SMS text messaging systems or integrated care platforms. Studies described improved perceived access to resources rather than clinical outcomes.

Older Adult Involvement in Technology Design

Of the 19 studies, only 4 (21.1%) explicitly described involving older adults or caregivers in technology design or refinement. Of these, 2 studies used usability testing only, which occurred late in the development cycle. Only 2 studies incorporated participatory or co-design approaches, allowing older adults to contribute to early-stage feature development.

This limited involvement highlights a critical gap between design practices and the needs of older adult users—a key theme in our narrative synthesis.

A summary of user involvement is presented in Table 2.

Table 2. Extent of older adult involvement in information and communication technology design, adaptation, or evaluation (n=19).
StudySample size, nOlder adult involvement during designType of involvement
Nischelwitzer et al [20]15NoInitial pilot testing only
Ali et al [21]31NoUsability testing after development
Ammann et al [22]803NoNot reported
Hess et al [23]47NoEnd user feedback only
Reeder et al [24]96NoPostdeployment evaluation
Jiménez-Fernández et al [25]22NoUsability evaluation
Ellis et al [26]20NoUsability or feasibility testing
Mira et al [27]99YesaCo-design: medication routine insights
Dasgupta et al [28]16NoUsability and performance testing
Costa et al [29]62NoInformal feedback
Georgsson and Staggers [30]10NoSatisfaction survey
Yan and Or [31]119NoLogging and perceived usefulness
Pariser et al [32]76NoTelemedicine use feedback
Lang et al [33]116NoUsability testing
Nambisan et al [34]20YesIterative prototyping
Traviss-Turner et al [35]22NoBehavior tracking input
Shi et al [36]64NoAttitudes and satisfaction assessment
Valdeverona et al [37]38NoAcceptability evaluation
Spinean et al [38]147NoEnd user adoption data

aItalicized text denotes studies with meaningful (but limited) co-design or development-stage input.

Themes Identified in the Narrative Synthesis

Through thematic analysis of charted data, 3 overarching themes emerged.

Theme 1: ICTs Commonly Target Single Behaviors Rather Than Multidimensional Self-Management

Most technologies (14/19, 73.7%) focused on only one self-management behavior, despite the high prevalence of multimorbidity in older adults. Physical activity and medication adherence dominated the intervention landscape, while diet and follow-up behaviors were underrepresented.

Theme 2: Limited Integration of Older Adults in Design and Development

Consistent with prior literature on participatory design, few studies included older adults in the design process, and involvement was often superficial. Studies that incorporated older adult or caregiver feedback reported improved usability, increased engagement, and greater perceived relevance. However, participatory co-design remains the exception rather than the norm.

Theme 3: Focus on Usability Over Effectiveness

Across studies, outcomes overwhelmingly emphasized usability, perceived usefulness, intention to use, and satisfaction. Few studies measured changes in actual self-management behavior or clinical outcomes, reflecting a broader trend toward feasibility or proof of concept research rather than rigorous evaluation.

Summary of Findings

The evidence base is diverse but fragmented. ICTs designed to support chronic disease self-management in older adults vary in purpose, technology type, and targeted behavior. Several key gaps were identified. These gaps included minimal involvement of older adults in technology design, scarcity of multidimensional or integrated self-management technologies, lack of objective outcome measures, and limited focus on follow-up appointment adherence and dietary behavior.

Additional Analyses: Qualitative Synthesis

Articles that reported technology interventions and included self-management aimed at improving chronic disease outcomes using either clinical or behavioral outcomes were eligible for systematic review inclusion (Table 3). We categorized the interventions into the following 4 self-management activities: medication behavior, physical activity, dietary behavior, and follow-up appointment attendance.

Table 3. Self-management behaviors targeted by information and communication technologies in the included studies (n=19).
StudyMedication behaviorFollow-up appointment attendancePhysical activityDietary behaviorReported outcomes related to behavior
Nischelwitzer et al [20]NoNoYesNoMeasured user input data including blood pressure and glucose level
Ali et al [21]NoNoNoYesMeasured perceived usefulness and ease of use
Ammann et al [22]NoNoYesNoa
Hess et al [23]YesNoNoNoMeasured glucose readings and appointment attendance
Reeder et al [24]YesNoNoNoMeasured perceived ease of use and usefulness
Jiménez-Fernández et al [25]YesNoNoNoMeasured degree of satisfaction and perceived ease of use
Ellis et al [26]NoNoYesNoMeasured walking activity and speed
Mira et al [27]YesNoNoNoMeasured adherence and missed doses
Dasgupta et al [28]YesNoYesNoMeasured health management skills, risk for depression, and self-reported physical activity
Costa et al [29]YesYesYesNoMeasured user perception
Georgsson and Staggers [30]YesYesYesYesMeasured perceived improvement
Yan and Or [31]YesNoNoNoMeasured actual use and perceived usefulness
Pariser et al [32]YesNoNoNoMeasured perceived access to clinical resources
Lang et al [33]YesNoNoNoMeasured actual use and perceived usefulness
Nambisan et al [34]NoNoYesYesMeasured physical activity and dietary log; condition tracking
Traviss-Turner et al [35]NoNoNoYesMeasured binge eating rate
Shi et al [36]NoNoYesYesMeasured improvement in exercise and dietary behaviors
Valdeverona et al [37]YesMeasured perceived usefulness and frequency of use
Spinean et al [38]NoNoYesYesMeasured adherence to physical activity recommendation and dietary recommendation

aIndicates that the applicable self-management behavior was not measured or included in the referenced study.


Principal Findings

Despite the extensive body of literature on technology use in chronic disease management, relatively few studies (n=19) have explicitly examined the role of ICTs in supporting self-management behaviors among adults aged 65 years and older. This finding underscores the relative underdevelopment of an evidence base that is both age specific and behaviorally grounded, despite the high burden of multimorbidity and chronic disease management demands in this population. Given the well-established link between the 4 key self-management behaviors (ie, medication adherence, attending medical appointments, engaging in physical activity, and maintaining a healthy diet) and chronic disease outcomes, future research on technology use in chronic disease management should specifically address these behaviors to ensure more concrete and actionable findings [18].

Importantly, the scoping nature of this review allows for identification of patterns and gaps across heterogeneous study designs rather than assessment of intervention effectiveness. Viewed through this lens, the limited number of studies focused explicitly on adults aged 65 years and older reflects not only a quantitative gap but also a conceptual one in how older adults are positioned within digital health research. Future studies should place particular emphasis on adults aged 65 years and older, a population with a high prevalence of multiple chronic conditions and a documented lower intention to use health information technologies designed for self-management [39,40].

The identified gap gains further significance in light of known predictors of technology use for disease management, particularly performance expectancy and social influence. Lower levels of these factors may contribute to suboptimal adoption and sustained use of ICTs among older adults with chronic diseases [41]. While several studies implicitly acknowledged these determinants, few explicitly incorporated them into intervention design or evaluation frameworks. Understanding these predictors is crucial for informing targeted interventions that address the specific needs, expectations, and social contexts of older adults.

An increasing body of literature highlights the importance of involving older adults in the design of technologies intended to support their health [9]. However, only a small subset of studies in this review reported meaningful involvement of older adults during early design or development phases, with most limiting engagement to late-stage usability testing. Emerging research further suggests that incorporating older adults’ caregivers and support networks into the design process can improve communication, strengthen social relationships, and enhance sustained technology use [17,42]. The limited adoption of participatory and co-design approaches identified in this review therefore represents a missed opportunity to align ICT development with the lived realities of aging with chronic disease.

Regarding technology types, mobile technologies and personalized applications were the most frequently reported, surpassing web-based and home-based solutions. This pattern aligns with broader literature on technology acceptance among older adults, which suggests that tablets and smartphones are often perceived as more accessible and easier to use than desktop or laptop computers [43,44]. However, the predominance of mobile solutions should not be interpreted as evidence of optimal fit for all older adults, particularly those with sensory, cognitive, or socioeconomic barriers that may limit access or sustained use.

The included studies addressed self-management behaviors related to physical activity, medication management, diet and nutrition, and follow-up appointment attendance. While social services and social connectedness were rarely targeted, 1 study using an interactive TV-based platform demonstrated promising outcomes related to access to services and social engagement, suggesting a potential role for ICTs in addressing social isolation as a component of chronic disease self-management [45,46]. This finding highlights the need to broaden conceptualizations of self-management beyond biomedical behaviors to include social and contextual dimensions that influence health and well-being in later life.

Implications for Practice and Future Research

This scoping review reveals several important opportunities for improving the design and implementation of ICTs that support chronic disease self-management in older adults.

First, expand the range and integration of self-management behaviors addressed. Future technologies should move beyond single-behavior interventions to reflect the multidimensional nature of chronic disease in older adults. Attention should also be given to social services as a self-management behavior, and exploration of technologies targeting social isolation is warranted.

Second, integrate older adults and caregivers across all stages of technology development. Participatory and co-design methodologies should be prioritized to ensure that ICTs align with users’ functional abilities, digital literacy, and everyday care contexts. Early-stage involvement, rather than post hoc usability testing alone, is particularly important for improving relevance and adoption.

Third, incorporate social and contextual determinants of technology use. Factors such as digital literacy, socioeconomic status, internet access, and social support networks are central to understanding ICT adoption and effectiveness among older adults. Future research should explicitly measure and report these contextual factors rather than treating them as background characteristics [43,47].

Fourth, adopt more robust evaluation approaches as technologies mature. While feasibility and usability studies remain appropriate at early stages, later-phase research should incorporate objective measures of behavior change, care processes, or health outcomes to better assess real-world impact.

Finally, develop technologies that support care continuity and follow-up. Appointment adherence and communication with health care providers remain underexplored yet highly relevant domains for older adults’ health outcomes and health care use.

Collectively, these implications underscore the need for more holistic, user-centered, and contextually informed ICT development strategies tailored to older adults managing chronic disease.

Strengths and Limitations

This review’s strengths include a comprehensive, librarian-assisted search strategy; adherence to PRISMA-ScR reporting guidelines; and a structured, iterative approach to data charting and thematic synthesis. By focusing on self-management behaviors rather than specific diseases or technologies alone, this review offers a behaviorally grounded map of the current evidence base that complements prior disease-specific reviews.

Several limitations should be noted. First, while this scoping review provides valuable insights into ICTs targeting older adults, it did not assess intervention effectiveness or quality, consistent with scoping review methodology. Second, the heterogeneity of study designs, populations, and outcome measures limited cross-study comparability. Third, gray literature was not included, which may have excluded emerging or non–peer-reviewed technologies relevant to older adults. Finally, although sociocultural and structural factors were identified as important gaps, these were infrequently reported in the included studies, limiting deeper analysis of their influence on ICT adoption and use [46,48].

Conclusions

This scoping review maps the current landscape of ICTs designed to support chronic disease self-management among adults aged 65 years and older, revealing a fragmented and uneven evidence base. Although a wide range of technologies has been developed, most focus on single self-management behaviors and provide limited evidence of meaningful older adult involvement in design or development.

The findings have important implications for aging researchers, health informatics scholars, and technology developers. Addressing the identified gaps, particularly the limited use of participatory design, the narrow focus on individual behaviors, and the lack of attention to social and contextual factors, will be essential for advancing more inclusive and effective ICT-based self-management support for older adults. As the population ages and the prevalence of multimorbidity increases, intentional, age-centered approaches to digital health design will be critical for improving chronic disease management and health equity in later life.

Funding

This study received no external funding.

Authors' Contributions

All 3 authors contributed equally to the development of the manuscript. Each author substantially participated in (1) the conception and design of the study, data collection, data analysis, and interpretation; (2) drafting and revising the manuscript for important intellectual content; and (3) approving the final version of the manuscript.

Conflicts of Interest

None declared.

Multimedia Appendix 1

Databases and search strings.

DOCX File, 18 KB

Checklist 1

PRISMA checklist.

DOCX File, 22 KB

  1. Ageing and health. World Health Organization. URL: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health [Accessed 2023-02-18]
  2. World population by age and region 2022. Statista. URL: https://www.statista.com/statistics/265759/world-population-by-age-and-region/ [Accessed 2023-12-05]
  3. Salive ME. Multimorbidity in older adults. Epidemiol Rev. 2013;35(1):75-83. [CrossRef] [Medline]
  4. Grady PA, Gough LL. Self-management: a comprehensive approach to management of chronic conditions. Am J Public Health. Aug 2014;104(8):e25-e31. [CrossRef] [Medline]
  5. Allegrante JP, Wells MT, Peterson JC. Interventions to support behavioral self-management of chronic diseases. Annu Rev Public Health. Apr 1, 2019;40:127-146. [CrossRef] [Medline]
  6. Celler BG, Lovell NH, Basilakis J. Using information technology to improve the management of chronic disease. Med J Aust. Sep 1, 2003;179(5):242-246. [CrossRef] [Medline]
  7. El-Gayar O, Timsina P, Nawar N, Eid W. Mobile applications for diabetes self-management: status and potential. J Diabetes Sci Technol. Jan 1, 2013;7(1):247-262. [CrossRef] [Medline]
  8. Ye Q, Boren SA, Khan U, Kim MS. Evaluation of functionality and usability on diabetes mobile applications: a systematic literature review. In: Duffy V, editor. Digital Human Modeling. Springer; 2017. [CrossRef] ISBN: 9783319584652
  9. Miah SJ. Information and communication technology-based innovations for aging healthcare: a literature review. Int J Comput Healthc. 2014;2(1):28-42. [CrossRef]
  10. Bohingamu Mudiyanselage S, Stevens J, Watts JJ, et al. Personalised telehealth intervention for chronic disease management: a pilot randomised controlled trial. J Telemed Telecare. Jul 2019;25(6):343-352. [CrossRef] [Medline]
  11. Quan-Haase A, Martin K, Schreurs K. Interviews with digital seniors: ICT use in the context of everyday life. Inf Commun Soc. 2016;19(5):691-707. [CrossRef]
  12. Fischer SH, David D, Crotty BH, Dierks M, Safran C. Acceptance and use of health information technology by community-dwelling elders. Int J Med Inform. Sep 2014;83(9):624-635. [CrossRef] [Medline]
  13. Khosravi P, Ghapanchi AH. Investigating the effectiveness of technologies applied to assist seniors: a systematic literature review. Int J Med Inform. Jan 2016;85(1):17-26. [CrossRef] [Medline]
  14. Mitzner TL, Sanford JA, Rogers WA. Closing the capacity-ability gap: using technology to support aging with disability. Innov Aging. 2018;2(1):igy008. [CrossRef] [Medline]
  15. Finkelstein R, Wu Y, Brennan-Ing M. Older adults’ experiences with using information and communication technology and tech support services in New York City: findings and recommendations for post-pandemic digital pedagogy for older adults. Front Psychol. Apr 17, 2023;14:1129512. [CrossRef] [Medline]
  16. Stamate A, Marzan MD, Velciu M, Paul C, Spiru L. Advancing user-centric design and technology adoption for aging populations: a multifaceted approach. Front Public Health. Dec 6, 2024;12:1469815. [CrossRef] [Medline]
  17. Swallow D, Petrie H, Power C, Lewis A, Edwards AD. Involving older adults in the technology design process: a case study on mobility and wellbeing in the built environment. Stud Health Technol Inform. 2016;229:615-623. [Medline]
  18. Fischer B, Peine A, Östlund B. The importance of user involvement: a systematic review of involving older users in technology design. Gerontologist. Oct 2020;60(7):e513-e523. [CrossRef]
  19. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. Dec 5, 2016;5:210. [CrossRef]
  20. Nischelwitzer A, Pintoffl, K, Loss C, Holzinger A. Design and development of a mobile medical application for the management of chronic diseases: methods of improved data input for older people. In: Holzinger A, editor. HCI and Usability for Medicine and Health Care. Springer; 2007. URL: http://link.springer.com/10.1007/978-3-540-76805-0 [CrossRef]
  21. Ali NM, Shahar S, Kee YL, Norizan AR, Noah SAM. Design of an interactive digital nutritional education package for elderly people. Inform Health Soc Care. Dec 2012;37(4):217-229. [CrossRef] [Medline]
  22. Ammann R, Vandelanotte C, de Vries H, Mummery WK. Can a website-delivered computer-tailored physical activity intervention be acceptable, usable, and effective for older people? Health Educ Behav. Apr 2013;40(2):160-170. [CrossRef] [Medline]
  23. Hess R, Fischer G, Weimer M. Abstracts from the 35th Annual Meeting of the Society of General Internal Medicine [Intensity of messaging necessary to encourage patients to access the PHR: preliminary results from the Smart-PHR study]. J Gen Intern Med. 2012;Suppl 2(Suppl 2):S231. [CrossRef] [Medline]
  24. Reeder B, Demiris G, Marek KD. Older adults’ satisfaction with a medication dispensing device in home care. Inform Health Soc Care. Sep 2013;38(3):211-222. [CrossRef] [Medline]
  25. Jiménez-Fernández S, de Toledo P, del Pozo F. Usability and interoperability in wireless sensor networks for patient telemonitoring in chronic disease management. IEEE Trans Biomed Eng. Dec 2013;60(12):3331-3339. [CrossRef] [Medline]
  26. Ellis T, Latham NK, DeAngelis TR, Thomas CA, Saint-Hilaire M, Bickmore TW. Feasibility of a virtual exercise coach to promote walking in community-dwelling persons with Parkinson disease. Am J Phys Med Rehabil. Jun 2013;92(6):472-481. [CrossRef] [Medline]
  27. Mira JJ, Navarro I, Botella F, et al. A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial. J Med Internet Res. Apr 4, 2014;16(4):e99. [CrossRef] [Medline]
  28. Dasgupta D, Reeves KG, Chaudhry B, Duarte M, Chawla NV. ESeniorCare: technology for promoting well-being of older adults in independent living facilities. Presented at: 2016 IEEE International Conference on Healthcare Informatics (ICHI). [CrossRef]
  29. Costa CR, Anido-Rifon LE, Fernandez-Iglesias MJ. An open architecture to support social and health services in a smart TV environment. IEEE J Biomed Health Inform. Mar 2017;21(2):549-560. [CrossRef] [Medline]
  30. Georgsson M, Staggers N. Patients’ perceptions and experiences of a mHealth diabetes self-management system. Comput Inform Nurs. Mar 2017;35(3):122-130. [CrossRef] [Medline]
  31. Yan M, Or C. A 12-week pilot study of acceptance of a computer-based chronic disease self-monitoring system among patients with type 2 diabetes mellitus and/or hypertension. Health Informatics J. Sep 2019;25(3):828-843. [CrossRef] [Medline]
  32. Pariser P, Pham TNT, Brown JB, Stewart M, Charles J. Connecting people with multimorbidity to interprofessional teams using telemedicine. Ann Fam Med. Aug 12, 2019;17(Suppl 1):S57-S62. [CrossRef] [Medline]
  33. Lang C, Voigt K, Neumann R, Bergmann A, Holthoff-Detto V. Adherence and acceptance of a home-based telemonitoring application used by multi-morbid patients aged 65 years and older. J Telemed Telecare. Jan 2022;28(1):37-51. [CrossRef] [Medline]
  34. Nambisan P, Stange KC, Lyytinen K, Kahana E, Duthie E, Potnek M. A comprehensive digital self-care support system for older adults with multiple chronic conditions: development, feasibility, and usability testing of myHESTIA. J Appl Gerontol. Feb 2023;42(2):170-184. [CrossRef] [Medline]
  35. Traviss-Turner G, Bowes E, Hill A, et al. Providing online guided Self-help for the management of binge eating in adults with type 2 diabetes: the POSE-D pilot study and process evaluation. Br J Nutr. Dec 14, 2024;132(11):1542-1552. [CrossRef] [Medline]
  36. Shi Y, Stanmore E, McGarrigle L, et al. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: co-design approach. Maturitas. Aug 2024;186:108027. [CrossRef] [Medline]
  37. Valdeverona K, Hughes L, Savory MA, Padilla BI. The use of SMS text messaging to improve glycemic control, diabetes self-management, and patient satisfaction. J Nurse Pract. May 2024;20(5):104956. [CrossRef]
  38. Spinean A, Mladin A, Carniciu S, Stănescu AMA, Serafinceanu C. Emerging methods for integrative management of chronic diseases: utilizing mHealth apps for lifestyle interventions. Nutrients. Apr 29, 2025;17(9):1506. [CrossRef] [Medline]
  39. Cutilli CC, Simko LC, Colbert AM, Bennett IM. Health literacy, health disparities, and sources of health information in U.S. older adults. Orthop Nurs. 2018;37(1):54-65. [CrossRef] [Medline]
  40. Fernández-Ballesteros R, Molina MÁ, Schettini R, del Rey ÁL. Promoting active aging through university programs for older adults: an evaluation study. GeroPsych (Bern). 2012;25(3):145-154. [CrossRef]
  41. Yousef CC, Salgado TM, Farooq A, et al. Predicting patients’ intention to use a personal health record using an adapted unified theory of acceptance and use of technology model: secondary data analysis. JMIR Med Inform. Aug 17, 2021;9(8):e30214. [CrossRef] [Medline]
  42. Dykes S, Chu CH. Now more than ever, nurses need to be involved in technology design: lessons from the COVID-19 pandemic. J Clin Nurs. Apr 2021;30(7-8):e25-e28. [CrossRef] [Medline]
  43. Damant J, Knapp M. What are the likely changes in society and technology which will impact upon the ability of older adults to maintain social (extra-familial) networks of support now, in 2025 and in 2040? Government Office for Science, UK; 2015. URL: https://researchonline.lse.ac.uk/id/eprint/63146/ [Accessed 2026-02-23]
  44. Wilson SA, Byrne P, Rodgers SE, Maden M. A systematic review of smartphone and tablet use by older adults with and without cognitive impairment. Innov Aging. Jan 6, 2022;6(2):igac002. [CrossRef] [Medline]
  45. Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatr Gerontol Int. Feb 2017;17(2):286-294. [CrossRef] [Medline]
  46. Tomaka J, Thompson S, Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health. Jun 2006;18(3):359-384. [CrossRef] [Medline]
  47. Yu RP, Ellison NB, McCammon RJ, Langa K. Mapping the two levels of digital divide: internet access and social network site adoption among older adults in the USA. Inf Commun Soc. 2015;19(10):1-20. [CrossRef]
  48. Diamantidis CJ, Becker S. Health information technology (IT) to improve the care of patients with chronic kidney disease (CKD). BMC Nephrol. Jan 9, 2014;15:7. [CrossRef] [Medline]


ICT: information and communication technology
MeSH: Medical Subject Headings
PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews


Edited by Matthew Balcarras, Naomi Cahill; submitted 14.May.2024; peer-reviewed by Fernanda Bastos, Marie-Eve Gagnon, Urjoshi Sinha; final revised version received 13.Jan.2026; accepted 13.Jan.2026; published 19.Mar.2026.

Copyright

© Paul Murdock, Yiyi Wu, Charles R Senteio. Originally published in the Interactive Journal of Medical Research (https://www.i-jmr.org/), 19.Mar.2026.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Interactive Journal of Medical Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.i-jmr.org/, as well as this copyright and license information must be included.