Digital Self-Management for Older Adults with Multimorbidity: The Role of Triage Nurse Support in Symptom Stabilisation

To appear in HCI International 2026, Montreal, Canada

Digital self-management technologies are increasingly used to support older adults living with multimorbidity. However, evidence remains limited on their long-term effectiveness and on the role of clinical support in shaping outcomes. This paper reports findings from the SEURO project Effectiveness Implementation Hybrid trial, focusing on symptom stabilisation as an indicator of self-management effectiveness and examining how triage nurse support influences stabilisation over time. Participants aged 65 years and older with two or more chronic conditions were randomised to use the ProACT digital health platform either with telephone-based triage nurse support (Arm 1, n=160) or without such support (Arm 2, n=160). Longitudinal physiological data collected over a six-month period across Ireland and Belgium were analysed relative to personalised alert thresholds set by triage nurses. Across multiple physiological measures, participants receiving triage nurse support generally exhibited more stable symptom trajectories, reflected in lower alert frequencies and smaller deviations from personalised thresholds. Differences were particularly evident in the Irish cohort, while Belgian participants demonstrated lower alert rates and greater stability across both trial arms. This paper contributes to HCI and digital health research by introducing and applying longitudinal, personalised stabilisation metrics - based on deviations from nurse-defined alert thresholds - to examine self-management over time in older adults with multimorbidity, and by providing cross-site quantitative evidence that embedding triage nurse support within a digital self-management intervention is associated with more stable symptom trajectories.