What do Cochrane systematic reviews say about telemedicine for healthcare?
Keywords:
Telemedicine, Electronic health records, Telerehabilitation, Telephone, Delivery of health careAbstract
BACKGROUND: Telemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have be-come more sophisticated and user-friendly. OBJECTIVE: We aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within health-care and to summarize the current evidence regarding its use. DESIGN AND SETTING: Review of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors. RESULTS: We included 10 CSRs that investigated a broad range of diseases. There is still insufficient ev-idence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed. CONCLUSION: Telemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.
Downloads
References
Maldonado JMSV, Marques AB, Cruz A. Telemedicina: desafios à sua difusão no Brasil [Telemedicine: challenges to dissemination in Brazil]. Cad Saúde Pública. 2016;32Suppl 2(Suppl 2):e00155615. PMID: 27828681; doi: 10.1590/0102-311X00155615.
Notes, short comments, and answers to correspondents. Lancet. 1879;114(2935):819-22. doi: 10.1016/S0140-6736(02)47536-8.
World Health Organization. Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth. 2009. Geneva: World Health Organization (Global Observatory for eHealth Series, 2) Available from: https://www.who.int/goe/publications/goe_telemedicine_2010.pdf. Accessed in 2019 (Apr 9).
World Health Organization. Health and Sustainable development: Telehealth. Available from: https://www.who.int/sustainable-development/health-sector/strategies/telehealth/en/. Accessed in 2019 (Apr 9).
Pagliari C, Sloan D, Gregor P, et al. What is eHealth (4): a scoping exercise to map the field. J Med Internet Res. 2005;7(1):e9. PMID: 15829481; doi: 10.2196/jmir.7.1.e9.
Craig J, Patterson V. Introduction to the practice of telemedicine. J Telemed Telecare. 2005;11(1):3-9. PMID: 15829036; doi: 10.1177/1357633X0501100102.
Rezende EJ, Melo M do C, Tavares EC, Santos A de F, Souza Cd. Ética e telessaúde: reflexões para uma prática segura [Ethics and eHealth: reflections for a safe practice]. Rev Panam Salud Publica. 2010;28(1):58-65. PMID: 20857022; doi: 10.1590/S1020-49892010000700009.
Vaona A, Pappas Y, Grewal RS, et al. Training interventions for improving telephone consultation skills in clinicians. Cochrane Database Syst Rev. 2017;1:CD010034. PMID: 28052316; doi: 10.1002/14651858. CD010034.pub2.
McLean S, Nurmatov U, Liu JL, et al. Telehealthcare for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011;7:CD007718. PMID: 21735417; doi: 10.1002/14651858.CD007718.pub2.
Kew KM, Cates CJ. Remote versus face‐to‐face check‐ups for asthma. Cochrane Database Syst Rev. 2016;4:CD011715. PMID: 27087257; doi: 10.1002/14651858.CD011715.pub2.
Kew KM, Cates CJ. Home telemonitoring and remote feedback between clinic visits for asthma. Cochrane Database Syst Rev. 2016;8:CD011714. PMID: 27486836; doi: 10.1002/14651858.CD011714.pub2.
Bittner AK, Wykstra SL, Yoshinaga PD, Li T. Telerehabilitation for people with low vision. Cochrane Database Syst Rev. 2015;8:CD011019. PMID: 26329308; doi: 10.1002/14651858.CD011019.pub2.
Khan F, Amatya B, Kesselring J, Galea M. Telerehabilitation for persons with multiple sclerosis. Cochrane Database Syst Rev. 2015;(4):CD010508; PMID: 25854331; doi: 10.1002/14651858.CD010508.pub2.
Laver KE, Schoene D, Crotty M, et al. Telerehabilitation services for stroke. Cochrane Database Syst Rev. 2013;12:CD010255. PMID: 24338496; doi: 10.1002/14651858.CD010255.pub2.
Tan K, Lai NM. Telemedicine for the support of parents of high‐risk newborn infants. Cochrane Database Syst Rev. 2012;(6):CD006818. PMID: 22696360; doi: 10.1002/14651858.CD006818.pub2.
Gentry S, van-Velthoven MH, Tudor Car L, Car J. Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. Cochrane Database Syst Rev. 2013;(5):CD009189. PMID: 23728687; doi: 10.1002/14651858.CD009189.pub2.
Inglis SC, Clark RA, Dierckx R, Prieto‐Merino D, Cleland JG. Structured telephone support or non‐invasive telemonitoring for patients with heart failure. Cochrane Database Syst Rev. 2015;(10):CD007228. PMID: 26517969; doi: 10.1002/14651858.CD007228.pub3.
Fisher E, Law E, Palermo TM, Eccleston C. Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2015;(3):CD011118. PMID: 25803793; doi: 10.1002/14651858. CD011118.pub2.
World Health Organization. Chronic obstructive pulmonary disease (COPD). 2017. Geneva: World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Accessed in 2019 (May 8).
Vitacca M, Montini A, Comini L. How will telemedicine change clinical practice in chronic obstructive pulmonary disease? Ther Adv Respir Dis. 2018;12:1753465818754778. PMID: 29411700; doi: 10.1177/1753465818754778.
Murphy LA, Harrington P, Taylor SJ, et al. Clinical-effectiveness of self-management interventions in chronic obstructive pulmonary disease: An overview of reviews. Chron Respir Dis. 2017;14(3):276-88. PMID: 28774200; doi: 10.1177/1479972316687208.
Hailey D, Roine R, Ohinmaa A, Dennett L. Evidence of benefit from telerehabilitation in routine care: a systematic review. J Telemed Telecare. 2011;17(6):281-7. PMID: 21844172; doi: 10.1258/jtt.2011.101208.
Johansson T, Wild C. Telerehabilitation in stroke care--a systematic review. J Telemed Telecare. 2011;17(1):1‐6. PMID: 21097560; doi: 10.1258/jtt.2010.100105.
Kairy D, Lehoux P, Vincent C, Visintin M. A systematic review of clinical outcomes, clinical process, healthcare utilisation and costs associated with telerehabilitation. Disabil Rehabil. 2009;31(6):427-47. PMID: 18720118; doi: 10.1080/09638280802062553.
Zhao J, Zhai YK, Zhu WJ, Sun DX. Effectiveness of telemedicine for controlling asthma symptoms: a systematic review and meta-analysis.
Telemed J E-Health. 2015;21(6):484-92. PMID: 25393915; doi: 10.1089/ tmj.2014.0119.
Sarfo FS, Ulasavets U, Opare-Sem OK, Ovbiagele B. Tele-rehabilitation after stroke: an updated systematic review of the literature. J Stroke Cerebrovasc Dis. 2018;27(9):2306-18. PMID: 29880211; doi: 10.1016/j. jstrokecerebrovasdis.2018.05.013.
