eHealth Self-Management Interventions for Patients With Liver Cirrhosis: Scoping Review

Abstract

Background: Liver cirrhosis (LC) is a morbid condition associated with frequent hospitalization and high mortality. Effective self-management is essential for patients with LC to monitor fluctuating symptoms and follow complex treatment regimens. However, strategies are often unsustainable and insufficiently tailored to individuals with cognitive impairments. Although eHealth interventions enable continuous monitoring, personalized guidance, and improved accessibility in other chronic conditions, comprehensive evidence for eHealth self-management interventions specifically tailored to patients with LC remains limited.

Objective: This scoping review systematically identified and described existing eHealth self-management interventions for patients with LC, analyzed their core components, and summarized the reported outcome variables.

Methods: Five electronic databases (PubMed, Embase, Cochrane Library, CINAHL, and Web of Science) were systematically searched for studies published between 2013 and June 2025. Interventional studies targeting adults with LC and involving eHealth-based self-management were included. Data on study design, intervention components, delivery methods, and outcome domains were extracted. The results were synthesized descriptively using the Arksey and O'Malley framework, and reporting followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

Results: Among 19,695 records screened, 9 studies met the inclusion criteria, comprising 1 randomized controlled trial, 2 quasi-experimental studies, 1 pilot test, 2 feasibility studies, 2 usability studies, and 1 cost-effectiveness study. The 8 intervention studies utilized smartphone apps or telephone and incorporated 6 key components: symptom monitoring (100% of the included studies), lifestyle behavior modification (n=5, 63%), information provision (n=5, 63%), alert-triggered responses (n=3, 38%), counseling and motivation (n=2, 25%), and reminders (n=2, 25%). The intervention durations ranged from 1 to 6 months. Among all 9 studies, outcomes were assessed across 5 domains: physical (n=3, 33%), psychosocial (n=2, 22%), clinical (n=4, 44%), self-management (n=3, 33%), and implementation (n=6, 67%). Some studies reported improvements in hospital admissions (n=4, 44%), muscle mass (n=1, 11%), self-management knowledge (n=1, 11%), and cost outcomes (n=1, 11%).

Conclusions: This review identified diverse eHealth self-management interventions with core components for patients with LC, evaluated across multiple outcome domains. Nonetheless, the evidence remains limited by small sample sizes and heterogeneous study designs and outcome measures. Future research should prioritize rigorous randomized trials, standardized intervention frameworks, and core outcome sets to support clinical implementation and effectiveness evaluation.