Using Large Language Models for Chronic Disease Management Tasks: Scoping Review

Abstract

Background: Chronic diseases present significant challenges in health care, requiring effective management to reduce morbidity and mortality. While digital technologies like wearable devices and mobile applications have been widely adopted, large language models (LLMs) such as ChatGPT are emerging as promising technologies with the potential to enhance chronic disease management. However, the scope of their current applications in chronic disease management and associated challenges remains underexplored. Objective: This scoping review investigates LLM applications in chronic disease management, identifies challenges, and proposes actionable recommendations. Methods: A systematic search for English-language primary studies on LLM use in chronic disease management was conducted across PubMed, IEEE Xplore, Scopus, and Google Scholar to identify articles published between January 1, 2023, and January 15, 2025. Of the 605 screened records, 29 studies met the inclusion criteria. Data on study objectives, LLMs used, health care settings, study designs, users, disease management tasks, and challenges were extracted and thematically analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results: LLMs were primarily used for patient-centered tasks, including patient education and information provision (18/29, 62%) of studies, diagnosis and treatment (6/29, 21%), self-management and disease monitoring (8/29, 28%), and emotional support and therapeutic conversations (4/29, 14%). Practitioner-centered tasks included clinical decision support (8/29, 28%) and medical predictions (6/29, 21%). Challenges identified include inaccurate and inconsistent LLM responses (18/29, 62%), limited datasets (6/29, 21%), computational and technical (6/29, 21%), usability and accessibility (9/29, 31%), LLM evaluation (5/29, 17%), and legal, ethical, privacy, and regulatory (10/29, 35%). While models like ChatGPT, Llama, and Bard demonstrated use in diabetes management and mental health support, performance issues were evident across studies and use cases. Conclusions: LLMs show promising potential for enhancing chronic disease management across patient and practitioner-centered tasks. However, challenges related to accuracy, data scarcity, usability, and ethical concerns must be addressed to ensure patient safety and equitable use. Future studies should prioritize the integration of LLMs with low-resource platforms, wearable and mobile technologies, developing culturally and age-appropriate interfaces, and establishing robust regulatory and evaluation frameworks to support safe, effective, and inclusive use in health care.