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Einstein (Sao Paulo, Brazil) 2024Heart failure is the leading cause of cardiac-related hospitalizations. Limited access to reevaluations and outpatient appointments restricts the application of modern... (Review)
Review
Heart failure is the leading cause of cardiac-related hospitalizations. Limited access to reevaluations and outpatient appointments restricts the application of modern therapies. Telemedicine has become an essential resource in the healthcare system because of its countless benefits, such as higher and more frequent appointments and faster titration of medications. This narrative review aimed to demonstrate the evidence and unresolved issues related to the use of telemedicine in patients with heart failure. No studies have examined heart failure prevention; however, several studies have addressed the prevention of decompensation with positive results. Telemedicine can be used to evaluate all patients with heart failure, and many telemedicine platforms are available. Several strategies, including both noninvasive (phone calls, weight measurement, and virtual visits) and invasive (implantable pulmonary artery catheters) strategies can be implemented. Given these benefits, telemedicine is highly desirable, particularly for vulnerable groups. Although some questions remain unanswered, the development of new technologies can complement remote visits and improve patient care.
Topics: Humans; Heart Failure; Telemedicine; Outpatients; Hospitalization
PubMed: 38451690
DOI: 10.31744/einstein_journal/2024RW0393 -
International Urogynecology Journal Jul 2023Telemedicine has been recommended for the management of urogynecological conditions during the coronavirus (COVID 19) pandemic. This study aimed to evaluate the... (Observational Study)
Observational Study
INTRODUCTION AND HYPOTHESIS
Telemedicine has been recommended for the management of urogynecological conditions during the coronavirus (COVID 19) pandemic. This study aimed to evaluate the feasibility of telemedicine for urogynecology at a Brazilian public hospital.
METHODS
A descriptive observational study was performed at a urogynecology outpatient clinic. The primary outcome was the desire to continue with telemedicine. Secondary outcomes were appointment resolvability, technical aspects of the appointment, and patient satisfaction. The participants had in-person appointments that were canceled because of the COVID-19 pandemic. We collected data on sociodemographic characteristics and clinical and technical aspects of the appointments. The participants responded to satisfaction questionnaires 7-15 days post-procedure. The categorical variables were evaluated based on absolute and relative frequency. The continuous variables were described as the mean and standard deviation. A chi-square test was performed to determine the association between variables.
RESULTS
In total, 225 patients had appointments canceled due to the COVID-19 pandemic, of which 171 were eligible for the study. Telemedicine appointments were agreed upon by 48% of the participants and 85.5% responded to the satisfaction survey. We found that 57.7% of the participants desired to continue with telemedicine. The appointment resolvability rate was 76.1%, 63.4% of the appointments met the technical criteria, and the satisfaction rate was 93%. The only variable associated with the desire to continue telemedicine was overall patient satisfaction (p=0.02).
CONCLUSIONS
Telemedicine in urogynecology is feasible and can be implemented in the studied population. However, actions are essential to adequately support patient preference and improve the acceptance of telemedicine.
Topics: Humans; COVID-19; SARS-CoV-2; Feasibility Studies; Pandemics; Patient Satisfaction; Telemedicine
PubMed: 36331581
DOI: 10.1007/s00192-022-05392-2 -
Pain Physician Nov 2023Telemedicine is an increasingly important tool in outpatient pain management. Telemedicine can be implemented through various strategies and a multitude of approaches... (Review)
Review
BACKGROUND
Telemedicine is an increasingly important tool in outpatient pain management. Telemedicine can be implemented through various strategies and a multitude of approaches have been described in existing literature.
OBJECTIVES
This scoping review aims to survey how telemedicine has been approached in published literature, providing insight for continued implementation.
STUDY DESIGN
Scoping review.
SETTING
Outpatient pain management.
METHODS
Ovid MEDLINE and Embase databases were queried. Two board-certified pain management physicians screened search results for relevant publications based on predetermined criteria. Included publications focused on outpatient pain management via live video or telephone and reported empirical outcomes. Publications were excluded that focused on acute pain, progressive muscle relaxation, physical therapy, or psychiatry, including cognitive behavioral therapy, or that primarily described educational modules, apps, mobile tracking, or automated calls. Nonfull publications (abstracts) and articles not available in English were also excluded. A third reviewer performed full-text screening, extracting variables of interest. Systematic reviews and meta-analyses were excluded from final selection.
RESULTS
Text and abstract screening of 3,302 results yielded 88 publications. Upon full-text screening, 64 additional publications were excluded, yielding 24 publications. High-quality randomized controlled trials (RCTs) were described in 5 (21%) publications, pilot RCTs in 4 (17%), prospective studies in 1 (4%), retrospective studies in 5 (21%), survey-based studies in 7 (29%), and other types of studies in 2 (8%). Cancer pain was the focus of 3 (13%) studies, headache/facial pain the focus of 4 (17%), musculoskeletal the focus of 3 (13%), and unspecified chronic pain the focus of 14 (58%). Patient experiences were the focus of 18 (75%) publications, provider experiences the focus of 2 (8%), and both patient and provider experiences the focus of 4 (17%). Outcome improvement measures were studied in 17 (71%) publications, process improvement measures in 5 (21%), and both types of measures in 2 (8%). Standard visits without on-site support were described in 4 (17%) publications, while standard visits with on-site support were described in 9 (38%). The remaining 11 (46%) described structured/integrated pain management programs. Positive pain-related outcomes were reported in 9 (38%) studies. Increased access or decreased barriers to care were reported in 9 (38%). Patient satisfaction was reported in 12 (50%) publications, with 10 (42%) describing positive results.
LIMITATIONS
This scoping review focused on telemedicine delivered via telephone or live video communication, excluding a substantial body of literature focused on virtual courses, modules, and other telehealth programs not involving live communication.
CONCLUSIONS
Current literature describes telemedicine implementation with various levels of technological and logistical support. Models of telemedicine represented in current literature include: standard visits with on-site support, standard visits without on-site support, and structured/integrated pain management programs. Presently, no literature has directly compared outcomes from these different approaches. Choice of model will depend on the specific goals and available resources. Patient satisfaction was studied most frequently and generally demonstrated positive results. Though current literature is heterogeneous and lacks RCTs, it consistently demonstrates benefits of telemedicine to patient satisfaction, pain, and access to care.
Topics: Humans; Outpatients; Chronic Pain; Patient Satisfaction; Headache; Telemedicine
PubMed: 37976479
DOI: No ID Found -
PloS One 2024Telemedicine is a useful tool for decreasing hospital stress, patient suffering, ambulance needs, hospital anxiety, and costs while improving the standard of care.... (Review)
Review
INTRODUCTION
Telemedicine is a useful tool for decreasing hospital stress, patient suffering, ambulance needs, hospital anxiety, and costs while improving the standard of care. Nonetheless, the lack of awareness regarding telemedicine poses a barrier to its application, presenting several difficulties in underdeveloped nations like Ethiopia. This review evaluates Ethiopian-specific telemedicine knowledge and associated factors.
METHODS
This systematic review was conducted using a search of several online databases in addition to the main databases, like Medline, PubMed, Scopus, and Science Direct. The writers have looked for, reviewed, and summarized information about telemedicine knowledge in the healthcare system. This study contained seven studies that examined telemedicine knowledge in the Ethiopian healthcare sector. Studies that followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) were found using search engines. The investigation was carried out using STATA version 11. The indicator of heterogeneity (I2) was used to assess the level of heterogeneity among the included studies. The funnel plot was visually inspected, and Egger's regression test was run to check for publication bias. The pooled effect size of every study is estimated using a random-effect model meta-analysis.
RESULTS
Examination of 2160 studies, seven studies involving 2775 health professionals, and seven out of the 2160 publications assessed satisfied the inclusion criteria and were added to the systematic review and meta-analysis. The pooled prevalence of Telemedicine knowledge was 45.20 (95% CI: 34.87-55.53). Whereas the pooled factor was computer training was 2.24 times (AOR = 2.24 (95%; CI: 1.64-3.08)), computer access was 2.07 times (AOR = 2.07 (95% CI: 1.50-2.87)), internet access was 3.09 times (AOR = 3.09 (95% CI: 1.34-7.13)), social media access were 3.09 times (AOR = 3.09(95%; CI: 1.34-7.13)), educational status degree and above were 2.73 times (AOR = 2.73; 95% CI: 0.85-8.82), Awareness were 3.18 times (AOR = 3.18 (95%; CI: 1.02-9.91)), Management support was 1.85 (AOR = 1.85 (95% CI: 01.25-2.75)), computer literacy were 2.90 times (AOR = 2.90 (95% CI: 1.81-4.64)), computer owner were 1.70 times (AOR = 1.70 (95% CI: 1.05-2.76)), male gender were 1.95 times (AOR = 1.95 (95% CI: 1.32-2.87)).
CONCLUSION
The overall pooled prevalence of telemedicine knowledge was low. Gender, education, management support, computer access, social media access, internet access, telemedicine awareness, and telemedicine training associated with telemedicine knowledge.
Topics: Humans; Male; Ethiopia; Systematic Reviews as Topic; Meta-Analysis as Topic; Telemedicine; Educational Status; Prevalence
PubMed: 38635662
DOI: 10.1371/journal.pone.0301044 -
Journal of Medical Internet Research Nov 2023Telehealth has been used for health care delivery for decades, but the COVID-19 pandemic greatly accelerated the uptake of telehealth in many care settings globally.... (Review)
Review
BACKGROUND
Telehealth has been used for health care delivery for decades, but the COVID-19 pandemic greatly accelerated the uptake of telehealth in many care settings globally. However, few studies have carried out a direct comparison among different telehealth modalities, with very few studies having compared the effectiveness of telephone and video telehealth modalities.
OBJECTIVE
This study aimed to identify and synthesize randomized controlled trials (RCTs) comparing synchronous telehealth consultations delivered by telephone and those conducted by video with outcomes such as clinical effectiveness, patient safety, cost-effectiveness, and patient and clinician satisfaction with care.
METHODS
PubMed (MEDLINE), Embase, and CENTRAL were searched via the Cochrane Library from inception until February 10, 2023, for RCTs without any language restriction. Forward and backward citation searches were conducted on included RCTs. The Cochrane Risk of Bias 2 tool was used to assess the quality of the studies. We included studies carried out in any health setting-involving all types of outpatient cohorts and all types of health care providers-that compared synchronous video consultations directly with telephone consultations and reported outcomes specified in the objective. We excluded studies of clinician-to-clinician telehealth consults, hospitalized patients, and asynchronous consultations.
RESULTS
Sixteen RCTs-10 in the United States, 3 in the United Kingdom, 2 in Canada, and 1 in Australia involving 1719 participants-were included in the qualitative and quantitative analyses. Most of the telehealth interventions were for hospital-based outpatient follow-ups, monitoring, and rehabilitation (n=13). The 3 studies that were conducted in the community all focused on smoking cessation. In half of the studies, nurses delivered the care (n=8). Almost all included studies had high or unclear risk of bias, mainly due to bias in the randomization process and selection of reported results. The trials found no substantial differences between telephone and video telehealth consultations with regard to clinical effectiveness, patient satisfaction, and health care use (cost-effectiveness) outcomes. None of the studies reported on patient safety or adverse events. We did not find any study on telehealth interventions for diagnosis, initiating new treatment, or those conducted in a primary care setting.
CONCLUSIONS
Based on a small set of diverse trials, we found no notable differences between telephone and video consultations for the management of patients with an established diagnosis. There is also a significant lack of telehealth research in primary care settings despite its high uptake.
Topics: Humans; Telephone; Telemedicine; Personal Satisfaction; Australia; Canada; Randomized Controlled Trials as Topic
PubMed: 37976100
DOI: 10.2196/49942 -
Circulation May 2024
Topics: Humans; Digital Technology; Telemedicine
PubMed: 38805579
DOI: 10.1161/CIRCULATIONAHA.124.068243 -
Romanian Journal of Ophthalmology 2023
Topics: Humans; Ophthalmology; Telemedicine; COVID-19
PubMed: 37876504
DOI: 10.22336/rjo.2023.36 -
Annals of Medicine Dec 2023The aim of this systematic review and meta-analysis was to identify, evaluate, and synthesize the evidence from studies that have investigated the treatment effect... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to identify, evaluate, and synthesize the evidence from studies that have investigated the treatment effect telemedicine interventions on depressive symptoms, quality of life, and work and social functioning in patients with depression. Six electronic databases (MEDLINE [1916-2021], PubMED [1950-2021], PsycINFO [1971-2021], Scopus [2004-2021], Embase [1972-2021], and CINAHL [1937-2021]) were systematically searched in March 2021. Reference lists of identified articles were hand searched. Randomized controlled trials were included if they investigated the treatment effects telemedicine interventions in patients who had a depression diagnosis. Quality assessment was evaluated using the critical appraisal checklists developed by the Joanna Briggs Institute. Seventeen (17) trials ( = 2,394) met eligibility criteria and were included in the analysis. Eleven (11) randomized controlled trials shared common outcome measures, allowing meta-analysis. The results provided evidence that treatment telemedicine interventions were beneficial for depressive symptoms (standardized mean difference= -0.44; 95% CI= -0.64 to -0.25; < .001) and quality of life (standardized mean difference= 0.25, 95% CI -0.01 to 0.49, = .04) in patients of depression. There were insufficient data for meta-analysis of work and social functioning. This study showed the positive effects of treatment telemedicine interventions on depressive symptoms and quality of life in patients with depression and supported the idea for clinical practice to establish a well-organized telepsychiatry system.KEY MESSAGESTelemedicine is effective at reducing symptoms of depression.Telemedicine can improve quality of life in persons with depression.
Topics: Humans; Depression; Quality of Life; Psychiatry; Telemedicine
PubMed: 36920229
DOI: 10.1080/07853890.2023.2187078 -
Journal of Medical Internet Research Jul 2023eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in... (Review)
Review
BACKGROUND
eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in childhood with an episodic course, requiring close follow-up of pediatric asthma control to identify disease deterioration, prevent exacerbations, and enhance quality of life. eHealth technologies in pediatric asthma care show promising results regarding feasibility, acceptability, and asthma-related health outcomes. However, broad systematic evaluations of eHealth technologies in pediatric asthma are lacking.
OBJECTIVE
The objective of this scoping review was to identify the types and applications of eHealth technologies for monitoring and treatment in pediatric asthma and explore which monitoring domains show the most relevance or potential for future research.
METHODS
A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic and comprehensive search was performed on English papers that investigated the development, validation, or application of eHealth technologies for home monitoring or treatment of pediatric asthma in the following databases: PubMed, Cochrane Library, IEEE, Scopus, CINAHL, PsycINFO, and ACM Digital Library. Two authors independently assessed eligibility and extracted data. Data were presented by a descriptive analysis of characteristics and a narrative report for each eHealth domain.
RESULTS
The review included 370 manuscripts. The following 10 monitoring domains were identified: air quality, airway inflammation markers, lung function, physical activity, sleep, audiovisual, other physiological measurements, questionnaires, medication monitoring, and digital environment (ie, digital platforms, applications, websites, and software tools to monitor or support monitoring). Rising numbers of studies were seen, and the numbers accelerated in the last few years throughout most domains, especially medication monitoring and digital environment. Limited studies (35/370, 9.5%) of multiparameter monitoring strategies, using three or more domains, were found. The number of monitoring validation studies remained stable, while development and intervention studies increased. Intervention outcomes seemed to indicate the noninferiority and potential superiority of eHealth monitoring in pediatric asthma.
CONCLUSIONS
This systematic scoping review provides a unique overview of eHealth pediatric asthma monitoring studies, and it revealed that eHealth research takes place throughout different monitoring domains using different approaches. The outcomes of the review showed the potency for efficacy of most monitoring domains (especially the domains of medication monitoring, lung function, and digital environment). Future studies could focus on modifying potentially relevant hospital-based diagnostics for the home setting to investigate potential beneficial effects and focus on combining home-monitoring domains to facilitate multiparameter decision-making and personalized clinical decision support.
Topics: Humans; Child; Quality of Life; Telemedicine; Asthma; Software; Sleep
PubMed: 37477966
DOI: 10.2196/45896 -
JMIR MHealth and UHealth Dec 2023Digital health technologies are widely used for disease management, with their computing platforms, software, and sensors being used for health care. These technologies... (Review)
Review
BACKGROUND
Digital health technologies are widely used for disease management, with their computing platforms, software, and sensors being used for health care. These technologies are developed to manage chronic diseases and infectious bacterial diseases, including tuberculosis (TB).
OBJECTIVE
This study aims to comprehensively review the literature on the use of digital health interventions (DHIs) for enhancing TB treatment adherence and identify major strategies for their adoption.
METHODS
We conducted a literature search in the PubMed, Cochrane Library, Ovid Embase, and Scopus databases for relevant studies published between January 2012 and March 2022. Studies that focused on web-based or mobile phone-based interventions, medication adherence, digital health, randomized controlled trials, digital interventions, or mobile health and ubiquitous health technology for TB treatment and related health outcomes were included.
RESULTS
We identified 27 relevant studies and classified them according to the intervention method, a significant difference in treatment success, and health outcomes. The following interventions were emphasized: SMS text messaging interventions (8/27, 30%), medicine reminders (6/27, 22%), and web-based direct observation therapy (9/27, 33%). Digital health technology significantly promoted disease management among individuals and health care professionals. However, only a few studies addressed 2-way communication therapies, such as interactive SMS text messaging and feedback systems.
CONCLUSIONS
This scoping review classified studies on DHIs for patients with TB and demonstrated their potential for the self-management of TB. DHIs are still being developed, and evidence on the impact of digital technologies on enhancing TB treatment adherence remains limited. However, it is necessary to encourage patients' participation in TB treatment and self-management through bidirectional communication. We emphasize the importance of developing a communication system.
Topics: Humans; Cell Phone; Text Messaging; Tuberculosis; Medication Adherence; Telemedicine
PubMed: 38054471
DOI: 10.2196/49741