**1. Introduction**

The sustainability of health systems depends to an extent on the ability of individuals to manage chronic diseases by taking responsibility for and participating in their care process [1,2]. In this context, continuity of care is a crucial element in the management of chronic diseases [3], particularly in the context of primary healthcare [4], where there is a need to promote a change in the care models adopted and to provide dedicated workforces. A transition is required toward a proactive approach that helps patients to achieve a higher level of autonomy in the management of their health conditions and that supports their self-care [5]. This approach can be effective at maintaining and improving health and quality of life and reduces complications, hospital admissions, and mortality [6,7].

eHealth, which is defined by WHO as the "use of information and communication technologies for health" [8], could be a fundamental tool for improving patient-centered care in health systems and self-care of non-communicable diseases (NCDs). Technologies that allow tracking and interventions and can be used by both healthcare professionals and patients/assistants include laptops, smartphones, Fitbit units, tablets, wearable sensors, videoconferencing, and GIS [9,10]. eHealth interventions for NCDs represent an opportunity to facilitate communication, stimulate the demand for services, and increase access to health information for disease management [11,12]. The use of digital technologies in the

**Citation:** Renzi, E.; Baccolini, V.; Migliara, G.; De Vito, C.; Gasperini, G.; Cianciulli, A.; Marzuillo, C.; Villari, P.; Massimi, A. The Impact of eHealth Interventions on the Improvement of Self-Care in Chronic Patients: An Overview of Systematic Reviews. *Life* **2022**, *12*, 1253. https:// doi.org/10.3390/life12081253

Academic Editor: Daniele Giansanti

Received: 1 August 2022 Accepted: 16 August 2022 Published: 17 August 2022

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**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

health context is a priority issue, especially considering the recent COVID-19 pandemic [13], which highlighted the need to implement sustainability of healthcare systems through digitization to enhance continuity of care. Indeed, the COVID-19 pandemic has led to a deterioration in self-care for patients suffering from NCDs [14], following a widespread disruption in chronic disease management services worldwide. In a WHO survey of the ability of different countries to address and respond to the growing burden of NCDs, 122 countries reported that the pandemic had caused delays and/or disruptions in their health services for chronic patients suffering from NCDs in 31% to 65% of cases. Services responsible for the management of patients with diabetes mellitus (T2DM), cardiovascular disease (CVD), and chronic obstructive pulmonary disease (COPD) showed a significant deterioration compared to baseline [15].

The implementation of eHealth and digital health measures appears to offer a viable means of improving the resilience of national health systems [16–18]. An understanding of the evidence on the effectiveness of eHealth interventions for the most common NCDs, with a focus on enhancing self-care, is crucial when planning and implementing person-centered care and interventions that involve patients in the management of their disease. However, most published systematic reviews have focused only on specific chronic diseases or single clinical outcomes (e.g., patients with heart failure, blood pressure levels). Here, our overview of systematic reviews aims to investigate the effectiveness of eHealth interventions at improving self-care in patients with chronic conditions, specifically those with type-2 diabetes mellitus, chronic obstructive pulmonary disease, and cardiovascular disease, when compared to standard care.
