The impact of digital self-management programmes on stroke survivors: a systematic review of randomised controlled trials.

Abstract

To synthesise evidence on the effectiveness of digital self-management programmes for stroke survivors' health outcomes, self-efficacy, and quality of life. Relevant English-language studies published between 2015 and 2025 were retrieved from PubMed, Embase, the Cochrane Library, Web of Science and Scopus databases. This systematic review was conducted in accordance with the PRISMA guidelines and registered with PROSPERO (CRD420251059348).Studies were included if they investigated digital self-management interventions for adult stroke survivors, with outcome measures including secondary prevention, self-efficacy, self-management ability, and quality of life. Study quality was assessed using the Cochrane Risk of Bias tool. Owing to substantial heterogeneity across digital platforms, intervention duration, and outcome measurement tools, a descriptive synthesis approach was adopted. A total of 12 randomised controlled trials (RCTs) involving 3,049 participants were included. Among these, all three studies assessing self-efficacy reported significant improvements in stroke survivors (p < 0.05), two out of three studies demonstrated enhanced self-management ability (p < 0.05), all six studies evaluating quality of life showed significant positive effects (p < 0.05), and all six studies assessing medication adherence reported improvement. However, effects on secondary prevention behaviours such as smoking, alcohol use, physical activity, and blood pressure control were inconsistent. Few studies assessed motor function or long-term outcomes. Intervention content, delivery platforms, and intensity varied widely. Digital self-management via technology shows positive impacts on self-efficacy, medication adherence, and quality of life in stroke survivors. The impact on motor rehabilitation remains unclear, indicating a need for further research. Digital self-management can enhance stroke survivors' self-efficacy and self-management abilities, promoting active rehabilitation. This intervention effectively improves medication adherence and quality of life but has limited impact on behaviour changes such as smoking cessation and alcohol reduction. It is important to consider integrating digital tools with conventional care while addressing patients' digital literacy and accessibility challenges. Further development and research are needed to evaluate the effects of digital self-management on stroke functional recovery and activity capacity.