Effectiveness of Co-Creation for Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

ObjectiveCo-creation is crucial for fostering active patient engagement in health management. However, the efficacy of co-creation in chronic disease management varies, and there is a lack of detailed description regarding co-creation practice. This study aimed to explore the effectiveness of co-creation on health outcomes and cost-effectiveness, detailing its implementation.Data SourcePubMed, Embase, Scopus, Cochrane Library and Web of Science.Study Inclusion and Exclusion CriteriaWe included peer-reviewed randomized controlled trials, published in English, that analyzed the effects of co-creation on physical health, participation outcomes, psychological health, self-efficacy and cost-effectiveness.Data ExtractionTwo researchers independently screened the articles and assessed the quality of the 16 included studies using a pre-prepared checklist.Data SynthesisMeta-analyses were conducted to summarize the characteristics, outcomes, and risk of bias of the included studies.ResultsThe results showed that co-creation significantly enhanced patients' physical health (P = 0.006) and participation outcomes (P = 0.009). Subgroup analysis revealed that co-creation combined with theory was better than co-creation without theory in improving physical health (P = 0.007). However, no significant difference was observed between the two groups regarding psychological health, self-efficacy and cost-effectiveness (P = 0.29) (P = 0.11) (P = 0.50).ConclusionCo-creation effectively improved patients' physical health and participation outcomes, without affecting psychological health, self-efficacy, and cost-effectiveness. Social determinants were found to play a more crucial role in influencing physical health of patients. Additionally, age disparities might impact the cost-effectiveness of co-creation. Future research should explore the influence of intergenerational co-creation on health promotion.