*3.3. Self-Care Improvements*

Improvements in self-care measurements were associated with an eHealth intervention in six of the eight systematic reviews [29,31–35]. Interventions led by multi-professional teams reported more effective results in improving self-care than eHealth interventions led by single professionals and/or research staff [32,34,35]. The overview of the effectiveness of eHealth interventions in improving self-care is described in the following paragraph based on the classification given in Table 1 (self-maintenance, monitoring, and management). Table 3 summarizes the effectiveness of eHealth interventions in improving self-care.


**Table 3.** Summary of the effectiveness of eHealth interventions at self-care improvement.

\* No meta-analysis. +: Statistically significant results in favor of the intervention. ns: results not statistically significant. Reminders: Reminders via SMS, MMS, messaging apps, email, and/or mobile apps. Telemonitoring: Telemonitoring and online operator support. Web-based education: Internet and web-based educational programs for smartphones, PCs, and apps.

#### 3.3.1. Self-Care Maintenance

Self-care maintenance was investigated in four systematic reviews (two with metaanalysis) [33–36] and consisted of interventions delivered via web-based education to a total of 15,441 patients. COPD patients registered a significant improvement in terms of self- maintenance, especially in terms of adherence to physical activity and stability of mental health [33]. These results were not confirmed in another systematic review, but this was one of the reviews assigned a "critically low quality" score in the AMSTAR assessment [35]. Web-based education also provided a statistically significant improvement in T2DM patients [34], especially in health education, on topics such as diet and how to monitor blood sugar. Improved self-care maintenance as a result of these eHealth interventions was especially marked in the elderly and those requiring home care [33].

#### 3.3.2. Self-Care Monitoring

Self-care monitoring was evaluated in three systematic reviews [29,31,32] with a total of 23,291 patients. One systematic review included reminder interventions and showed a positive improvement in self-care monitoring in patients with T2DM [29], especially for monitoring blood sugar and weight. For telemonitoring, we included two systematic reviews [31,32], where we recorded an improvement in self-care monitoring only in patients with CVD for the daily assessment of blood pressure values, especially when interventions were provided by a multi-professional team (physician, nurse, pharmacist) [32].
