School of Nursing, University of British Columbia, Okanagan, Kelowna, Canada.
Irving K. Barber School of Arts and Sciences, University of British Columbia, Okanagan, Kelowna, Canada.
Patient Educ Couns. 2018 Aug;101(8):1310-1321. doi: 10.1016/j.pec.2018.02.006. Epub 2018 Feb 15.
The virtual delivery of patient education and other forms of telehealth have been proposed as alternatives to providing needed care for patients with chronic diseases. The purpose of this systematic review was to compare the efficacy of virtual education delivery on patient outcomes compared with usual care.
The review examined citations from 3 databases, MEDLINE, CINAHL, and EMBASE using the search words telehealth, chronic disease, patient education, and related concepts. From 2447 records published between 2006 and 2017, 16 high to moderate quality studies were selected for review. Eligible papers compared virtual education to usual care using designs allowing for assessment of causality.
Telehealth modalities included the web, telephone, videoconference, and television delivered to patients with diabetes, chronic obstructive pulmonary disease, irritable bowel syndrome and heart failure. In 11 of 16 studies, virtually delivered interventions significantly improved outcomes compared to control conditions. In the remaining 5 studies, virtual education showed comparable outcomes to the control conditions.
Findings demonstrated that virtual education delivered to patients with chronic diseases was comparable, or more effective, than usual care.
Despite its benefits, there is potential for further research into the individual components which improve effectiveness of virtually delivered interventions.
为慢性疾病患者提供所需护理，提出了虚拟患者教育和其他形式的远程医疗作为替代方案。本系统评价的目的是比较虚拟教育与常规护理对患者结局的疗效。
本综述查阅了 2006 年至 2017 年间 MEDLINE、CINAHL 和 EMBASE 三个数据库中的引文，使用的检索词包括远程医疗、慢性病、患者教育和相关概念。在已发表的 2447 条记录中，选择了 16 项高质量的研究进行综述。符合条件的论文使用允许评估因果关系的设计将虚拟教育与常规护理进行比较。
远程医疗模式包括向糖尿病、慢性阻塞性肺疾病、肠易激综合征和心力衰竭患者提供网络、电话、视频会议和电视。在 16 项研究中的 11 项中，与对照条件相比，虚拟干预显著改善了结果。在其余 5 项研究中，虚拟教育与对照条件显示出可比的结果。
研究结果表明，向慢性病患者提供的虚拟教育与常规护理一样有效，甚至更有效。
尽管有其益处，但仍有潜力对提高虚拟干预效果的各个组成部分进行进一步研究。
