Digital interventions for NCDs soar post-COVID, but gaps in LMICs persist

A global analysis of digital interventions for non-communicable diseases (NCDs) has revealed rising momentum, regional disparities, and untapped opportunities in transforming healthcare through technology.

The study, titled “Digital Horizons in Non-Communicable Disease Care: A Bibliometric Exploration of Intervention Impact and Innovation” and published in Frontiers in Digital Health, offers a comprehensive bibliometric review of 9,572 publications between 2014 and 2024. The research dissects scientific output, trends, and collaborative networks shaping this critical public health field.

How has research on digital interventions for NCDs evolved over time?

The global research community has shown accelerating interest in digital health solutions for NCDs, with a dramatic rise in publications since 2018. According to the study, the number of annual publications peaked in 2021 at 1,536 articles, reflecting intensified academic engagement during the COVID-19 pandemic. Although the post-2021 period saw a slight decline, overall interest has stabilized at high levels, indicating a maturing research domain.

Medicine emerged as the leading discipline (61.5% of publications), followed by biochemistry, health professions, nursing, and engineering. This interdisciplinary blend underscores digital health’s integration into both clinical and technological spheres.

Notably, the United States and United Kingdom dominated the research landscape, contributing 3,884 and 1,196 articles respectively. Harvard Medical School led all institutions with 263 publications, while top journals included the Journal of Medical Internet Research, Telemedicine and E-Health, and BMJ Open.

The most cited study was a 2020 article from India on the psychosocial impact of COVID-19, which received 1,244 citations, demonstrating the intersection of digital health and mental health during global crises. Other frequently cited works addressed machine learning applications in diabetes care and telemedicine for oncology.

Who are the key contributors, and how is the global research network structured?

The research identified 51,858 contributing authors and 37,779 institutions, with ten authors accounting for 2.5% of the total scholarly output. Among the most prolific were H.B. Bosworth (Duke Clinical Research Institute), L. Yardley (UK Health Security Agency), and R.J. McManus (University of Oxford), each having authored over 20 papers with significant citation counts.

The bibliometric network analysis using VOSviewer revealed dense collaboration clusters, primarily among institutions in high-income countries. The United States formed the strongest co-authorship links (link strength = 1,611), followed by the UK, Italy, and Germany. However, such collaboration was mostly intra-national, with limited North–South or intercontinental engagement, highlighting a research gap for low- and middle-income countries (LMICs).

The most active funding bodies were also disproportionately based in the U.S., led by the National Institutes of Health (1,015 studies funded), the Department of Health and Human Services, and the National Cancer Institute. Only one top funder, the European Commission, was non-national, and funding support for LMICs was notably sparse.

This skewed institutional and financial backing underscores a need for equitable global investment, especially as LMICs bear the brunt of NCD-related mortality but remain underrepresented in digital health research.

What themes are emerging and where are the research gaps?

The thematic and keyword analysis revealed five dominant research clusters:

1. Mobile Health and Self-Management: Keywords like “telemedicine,” “mHealth,” “hypertension,” and “self-management” were most prevalent. This cluster reflects a focus on smartphone-enabled chronic care, especially for hypertension and diabetes.
2. Lifestyle and Mental Health Interventions: A second cluster centered on digital support for depression, physical activity, and quality of life, often through e-health platforms and internet-based programs.
3. AI in Public Health and Diabetes Prevention: Artificial intelligence, machine learning, and digital screening tools for diabetic retinopathy and other NCDs represented an emerging yet underdeveloped theme.
4. Remote Monitoring for Respiratory and Cardiac Conditions: Terms like COPD, asthma, and telehealth reflected growing interest in remote care delivery for chronic conditions.
5. Pandemic and Oncology Responses: The COVID-19 pandemic and cancer care were prominently featured in studies on digital adaptation and resilience.

Using a thematic map, the study classified these topics into "motor themes" (digital health, mHealth, oncology), "niche themes" (dermatology, melanoma), "basic themes" (diabetes, hypertension), and "emerging themes" (AI, retinopathy). Notably, AI and real-world screening interventions remained underdeveloped despite their growing importance.

Furthermore, trending keywords since 2019, such as “conversational agents,” “colorectal cancer screening,” and “implementation science”, point to shifting priorities toward precision medicine, virtual assistants, and care delivery transformation.

Co-citation analysis of references and journals reinforced these findings, identifying seminal works in behavioral theory, telemedicine implementation, and e-health ethics. Leading journals, The Lancet, JAMA, Diabetes Care, were repeatedly cited, indicating a consolidated body of knowledge around digital interventions.

What implications do these findings hold for future research and policy?

This study offers a roadmap for optimizing digital interventions against NCDs globally. It suggests that while developed nations lead in innovation and scholarly output, there is a pressing need to scale effective models in resource-limited settings. The findings recommend:

• Increased Investment in LMICs: Countries like India, with rising NCD burdens, need enhanced funding and infrastructure for digital health adoption beyond hospital-centric models.
• Focus on Real-World Impact: More studies are required on the scalability, personalization, and integration of digital tools into existing health systems, especially for patient-centered and preventive care.
• Policy Standardization: Regulatory harmonization and digital literacy promotion can bridge access gaps in underserved populations.
• Research-Industry Synergy: Collaboration between academia, tech developers, and policymakers will be essential in deploying AI, telemonitoring, and m-health applications at scale.

Examples such as India’s mMitra, Kenya’s AfyaPap, and Brazil’s Telehealth Network illustrate local innovations with global relevance. Yet, these models face systemic barriers like infrastructure deficits, regulatory ambiguity, and healthcare workforce shortages.