Centre for Online Health, The University of Queensland, Australia.
Centre for Health Services Research, The University of Queensland, Australia.
J Telemed Telecare. 2023 Oct;29(9):669-684. doi: 10.1177/1357633X211022907. Epub 2021 Jun 29.
To promote telehealth implementation and uptake, it is important to assess overall clinical effectiveness to ensure any changes will not adversely affect patient outcomes. The last systematic literature review examining telehealth effectiveness was conducted in 2010. Given the increasing use of telehealth and technological developments in the field, a more contemporary review has been carried out. The aim of this review was to synthesise recent evidence associated with the clinical effectiveness of telehealth services.
A systematic search of 'Pretty Darn Quick'-Evidence portal was carried out in November 2020 for systematic reviews on telehealth, where the primary outcome measure reported was clinical effectiveness. Due to the volume of telehealth articles, only systematic reviews with meta-analyses published between 2010 and 2019 were included in the analysis.
We found 38 meta-analyses, covering 10 medical disciplines: cardiovascular disease ( = 3), dermatology ( = 1), endocrinology ( = 13), neurology ( = 4), nephrology ( = 2), obstetrics ( = 1), ophthalmology ( = 1), psychiatry and psychology ( = 7), pulmonary ( = 4) and multidisciplinary care ( = 2). The evidence showed that for all disciplines, telehealth across a range of modalities was as effective, if not more, than usual care.
This review demonstrates that telehealth can be equivalent or more clinically effective when compared to usual care. However, the available evidence is very discipline specific, which highlights the need for more clinical effectiveness studies involving telehealth across a wider spectrum of clinical health services. The findings from this review support the view that in the right context, telehealth will not compromise the effectiveness of clinical care when compared with conventional forms of health service delivery.
为了促进远程医疗的实施和采用，评估整体临床效果非常重要，以确保任何改变都不会对患者的结果产生不利影响。上一次对远程医疗效果进行的系统文献综述是在 2010 年进行的。鉴于远程医疗的使用不断增加和该领域的技术发展，进行了更具时代性的审查。本次审查的目的是综合与远程医疗服务临床效果相关的最新证据。
2020 年 11 月，在“相当快”证据门户系统地搜索了关于远程医疗的系统评价，其中报告的主要结果衡量标准是临床效果。由于远程医疗文章的数量较多，仅纳入了 2010 年至 2019 年期间发表的具有荟萃分析的系统评价进行分析。
我们发现了 38 项荟萃分析，涵盖了 10 个医学学科：心血管疾病（ = 3）、皮肤病学（ = 1）、内分泌学（ = 13）、神经病学（ = 4）、肾脏病学（ = 2）、妇产科（ = 1）、眼科（ = 1）、精神病学和心理学（ = 7）、肺病学（ = 4）和多学科护理（ = 2）。证据表明，对于所有学科，远程医疗在各种模式下的效果与常规护理一样，甚至更有效。
本综述表明，与常规护理相比，远程医疗在很多情况下同样有效，甚至更有效。然而，现有的证据非常特定于学科，这突出表明需要进行更多涉及远程医疗的临床效果研究，涵盖更广泛的临床保健服务。本综述的结果支持这样一种观点，即在适当的情况下，与传统形式的医疗服务提供相比，远程医疗不会影响临床护理的效果。
