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J Am Med Inform Assoc 6:272-282 doi:10.1136/jamia.1999.0060272
  • The Practice of Informatics

Computer-based Approaches to Patient Education

Table 1

Research Reported in the Literature

No. in Study Length of Study Study Design Age Group Disease or Event, and Intervention Findings Significant for Experimental Group (P < 0.05), Including Effect Sizes (ES) Findings Significant for All Study Participants*
Fisher et al., 197734 99 3 wk Volunteer sample, random group assignment Adults 18-25 yr Urine collection More uniform skill performance, decreased bacterial count (ES 0.33), and decreased procedure problems
Three groups: CAI, text or human instruction
Millstein & Irwin, 198354 108 5 mo Randomized (three groups) Adolescents 14-20 yr Sexual history Satisfaction with survey (ES 0.43)
Interview, self-administered questionnaire, or computerized assessment
Wetstone et al., 198547 36 34 day Randomized (two groups stratified by education level) Adults: avg age 50.9 yr Rheumatoid arthritis Improved knowledge, improved self-care (joint protection and rest) and hope, improved outlook, and decreased fatalism Improved self-reported compliance
CAI or traditional instruction
Rubin et al., 198632 65 1 yr Randomized (two groups) Children 7-12 yr Asthma Improved disease management, health related behaviors (ES 0.72), and knowledge (ES 0.98)
Educational game or entertainment game
Wise et al., 198620 174 4-6 mo Randomized (stratified by year and month of birth) Adults 23-72 yr Diabetes Improved knowledge (IDDM group ES 0.41, NIDDM group ES 0.69) and decreased HgbA1 (ES 0.74)
CAI (two different interventions) or traditional instruction
Rippey et al., 198746 72 Pre- and post-test Convenience Elderly 52-88 yr Arthritis Improved knowledge (ES 0.94) and self-care behaviors (joint rest ES 0.53, heat ES 0.49, relaxation ES 0.64 and exercise ES 0.37)
CAI
Leirer et al., 198841 16 14 day Randomized cross-over Adults: “elderly” Medication recall Decreased nonadherence (ES 1.14)
CAI or traditional training
Marrero et al., 198912 57 4 mo Randomized (two groups stratified by age and sex) Adolescents 10-18 yr Diabetes Increase in self-reported understanding of treatment, increased perceived importance of testing, improved quality of interaction with physician Improved HgbA1c
One group used glucose meter with data storage; the other used text logs to record glucose values
Horan et al., 19908 20 15 wk Randomized (two groups)† Adolescents 12-19 yr Diabetes Improved pre-lunch and pre-dinner blood glucose results Improved HgbA1c and knowledge
CAI plus data management or print material
Huss et al., 199130 52 12 wk Randomized (two groups) Adults 18-75 yr Atopic asthma Improved adherence to therapy between CAI and traditional instruction (ES 0.64)
CAI or CAI and traditional instruction
Peters et al., 199116 42 32 day Randomized (two groups) Adults 22-45 yr Diabetes Decreased insulin required (ES 0.35) Improved HgbA1c, decreased hypoglycemia
CAI and traditional support for therapy decisions
Turnin et al., 199219 105 1 yr Randomized (two groups cross-over) Adults 42-47 yr Diabetes Improved knowledge (ES 1.91), decreased fat intake (ES 0.48), decreased HgbA1 (ES 0.80)
Access to a distributed learning system
Ogozalek, 199315 64 Pre- and post-test Selection criteria unclear Elderly 65-75 yr Medication information Improved knowledge score with computer and IVD (ES 0.41) and between computer and IVD (ES 1.3) Improved knowledge with text-based computer
Leaflets, text-based computer, or IVD
Meyerhoff et al., 199414 24 3 yr Volunteers (three groups), length-of-time meter used Adults 17-50 yr Diabetes Improved HgbA1c (ES 1.12)
Glucose meter with data storage
Osman et al., 199431 801 1 yr Randomized (two groups) Adults 48-51 yr Asthma Decreased hospital admission (ES 0.85)
Treatment group received computer-generated books
Liao et al., 199628 68 Pre- and post-test Volunteers (pilot study) Adults: avg age 61 yr Coronary artery disease Increased confidence in treatment choices
IVD
Madoff et al., 199642 42 + 13 from pilot 3 mo Randomized (two groups) Adults: avg age 35 yr Psychiatric patients Medication knowledge (ES 1.54) Improved knowledge retention and medication compliance
CAI or traditional instruction
Petersen, 199625 15 Pre- and post-test Convenience Children 9-16 yr Oncology blood counts Improved knowledge (ES 1.78)
CAI
Brown et al., 19973 59 6 mo Randomized (two groups) Children 8-16 yr Diabetes Communication with parents about diabetes (ES 0.21), self-care rating scale (ES 0.37) Improved HgbA1c and knowledge
Educational game or entertainment game
Clark et al., 199727 814 12 wk Randomized (two groups) Adults: “middle age” Hyperlipidemia Decreased plasma cholesterol (ES 0.58) Decreased self-report of consumption of dietary fat and cholesterol
CAI or traditional instruction
Evans et al., 199833 43 18 mo Convenience sample Children 8-10 yr Nocturnal enuresis Improved knowledge score
CAI pre- and post-test

  • Note: CAI indicates computer-assisted instruction; IVD, interactive video disk; IDDM, insulin-dependent diabetes mellitus; NIDDM, non-insulin-dependent diabetes mellitus.

  • ↵* No between-group differences.

  • ↵† Groups matched for age, sex, race, HgbA1c, and diabetes knowledge.

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