The Use of Digital Health Tools to Enhance Treatment Adherence and Quality of Life in Adolescents with Cystic Fibrosis a systematic review article

Background Cystic fibrosis (CF) is a hereditary progressive disease characterized by thick mucus in the lungs and digestive system, causing respiratory and gastrointestinal complications. Adolescents with CF face complex and demanding treatments including inhaled medications, airway clearance physiotherapy, exercise, and nutritional support, all requiring consistent adherence for optimal health. However, adherence often declines during adolescence, which can worsen health outcomes and reduce quality of life (QoL). Digital health tools have emerged as promising supports by providing accessible, personalized, and interactive methods to aid self-management and improve adherence. With rapid advances in technology and increasing adoption in CF care, it is vital to evaluate their effectiveness in this vulnerable population. Methods: A systematic review was conducted by searching PubMed, Scopus, and Web of Science for studies published in the last ten years. The review focused on digital health interventions to improve treatment adherence or quality of life in adolescents (۱۰-۱۹ years) with cystic fibrosis. Eligible designs included RCTs and quasi-experimental studies. Studies without adolescent data, non-digital interventions, or lacking adherence/QoL outcomes were excluded. Two independent reviewers screened studies and extracted data on intervention type, study design, sample size, outcomes, and follow-up. Study quality was assessed using standardized tools, and PRISMA guidelines were followed. Results: Digital health tools generally enhanced treatment adherence. Platforms like CF Health Hub combined digital adherence monitoring with behavioral support, increasing adherence rates and reducing hospital admissions. Mobile apps featuring gamification and scheduling aids also showed positive engagement and adherence outcomes, though evidence quality varied. Quality of life findings were less consistent. Some studies reported modest improvements in physical activity, self-management skills, and self-efficacy through digital exercise programs, symptom tracking, and peer support forums. However, validated QoL scores often revealed limited or no significant change, potentially due to short study durations or waning user engagement. Challenges include maintaining long-term use, integrating digital tools into clinical workflows, addressing privacy concerns, and tailoring interventions to adolescent developmental and psychosocial needs. Conclusion: Digital health tools offer potential to improve treatment adherence and possibly quality of life in adolescents with cystic fibrosis. While evidence supports better adherence, sustained engagement and significant QoL improvement remain challenges. Future work should focus on developing personalized, comprehensive digital solutions co-designed with adolescents and evaluated in long-term studies to maximize clinical and quality-of-life benefits.

کلیدواژه ها:

Digital Health Tools ، Treatment Adherence ، Quality of Life ، Adolescents ، Cystic Fibrosis