Leochico Carl Froilan D, Espiritu Adrian I, Ignacio Sharon D, Mojica Jose Alvin P
Department of Rehabilitation Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Taguig, Philippines.
Front Neurol. 2020 Sep 8;11:1007. doi: 10.3389/fneur.2020.01007. eCollection 2020.
Despite being known abroad as a viable alternative to face-to-face consultation and therapy, telerehabilitation has not fully emerged in developing countries like the Philippines. In the midst of the coronavirus disease 2019 (COVID-19) pandemic, wherein social distancing disrupted the in-clinic delivery of rehabilitation services, Filipinos attempted to explore telerehabilitation. However, several hindrances were observed especially during the pre-implementation phase of telerehabilitation, necessitating a review of existing local evidences. We aimed to determine the challenges faced by telerehabilitation in the Philippines. We searched until March 2020 through PubMed, Scopus, Embase, Cochrane Library, and HeRDIN for telerehabilitation-related publications wherein Filipinos were involved as investigator or population. Because of the hypothesized low number of scientific outputs on telerehabilitation locally, we performed handsearching through gray literature and included relevant papers from different rehabilitation-related professional organizations in the Philippines. We analyzed the papers and extracted the human, organizational, and technical challenges to telerehabilitation or telehealth in general. We analyzed 21 published and 4 unpublished papers, which were mostly reviews (8), feasibility studies (6), or case reports/series (4). Twelve out of 25 studies engaged patients and physicians in remote teleconsultation, teletherapy, telementoring, or telemonitoring. Patients sought telemedicine or telerehabilitation for general medical conditions (in 3 studies), chronic diseases (2), mental health issues (2), orthopedic problems (2), neurologic conditions (1), communication disorders (1), and cardiac conditions (1). Outcomes in aforementioned studies mostly included telehealth acceptance, facilitators, barriers, and satisfaction. Other studies were related to telehealth governance, legalities, and ethical issues. We identified 18 human, 17 organizational, and 18 technical unique challenges related to telerehabilitation in the Philippines. The most common challenges were slow internet speed (in 10 studies), legal concerns (9), and skepticism (9). There is paucity of data on telerehabilitation in the Philippines. Local efforts can focus on exploring or addressing the most pressing human, organizational, and technical challenges to the emergence of telerehabilitation in the country.
尽管远程康复在国外被视为面对面咨询和治疗的可行替代方案，但在菲律宾等发展中国家尚未完全兴起。在2019年冠状病毒病（COVID-19）大流行期间，社交距离扰乱了康复服务的门诊提供，菲律宾人试图探索远程康复。然而，特别是在远程康复的实施前期阶段，观察到了一些障碍，因此有必要对现有的本地证据进行审查。我们旨在确定菲律宾远程康复面临的挑战。我们在2020年3月之前通过PubMed、Scopus、Embase、Cochrane图书馆和HeRDIN搜索了与远程康复相关的出版物，其中菲律宾人作为研究者或研究对象参与其中。由于假设本地关于远程康复的科学产出数量较少，我们通过灰色文献进行了手工检索，并纳入了菲律宾不同康复相关专业组织的相关论文。我们分析了这些论文，并提取了远程康复或一般远程医疗在人力、组织和技术方面的挑战。我们分析了21篇已发表和4篇未发表的论文，这些论文大多是综述（8篇）、可行性研究（6篇）或病例报告/系列（4篇）。25项研究中有12项让患者和医生参与远程会诊、远程治疗、远程指导或远程监测。患者因一般医疗状况（3项研究）、慢性病（2项）、心理健康问题（2项）、骨科问题（2项）、神经系统疾病（1项）、沟通障碍（1项）和心脏疾病（1项）寻求远程医疗或远程康复。上述研究的结果大多包括远程医疗的接受度、促进因素、障碍和满意度。其他研究涉及远程医疗治理、合法性和伦理问题。我们确定了与菲律宾远程康复相关的18项人力、17项组织和18项技术独特挑战。最常见的挑战是网速慢（10项研究）、法律问题（9项）和怀疑态度（也有9项）。菲律宾关于远程康复的数据匮乏。当地的努力可以集中在探索或解决该国远程康复出现面临的最紧迫的人力、组织和技术挑战上。
