The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, United States of America.
Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, United States of America.
PLoS One. 2021 Jul 22;16(7):e0254896. doi: 10.1371/journal.pone.0254896. eCollection 2021.
When caregivers cannot attend the clinic visit for the person they provide care for, patients are the predominant source of clinic visit information; however, poor patient recall inhibits the quality of information shared, resulting in poor caregiver preparedness and contributing to caregiver morbidity. Technological solutions exist to sharing clinic visit information, but their effectiveness is unclear.
To assess if and how technology is being used to connect informal caregivers to patient clinic visit information when they cannot otherwise attend, and its impact on caregiver and patient outcomes.
MEDLINE, Cochrane, Scopus, and CINAHL were searched through 5/3/2020 with no language restrictions or limits. ClinicalTrials.gov and other reference lists were included in the search. Randomized controlled trials (RCTs) and nonrandomized trials that involved using a technological medium e.g., video or the electronic health record, to communicate visit information to a non-attending caregiver were included. Data were collected and screened using a standardized data collection form. Cochrane's Risk of Bias 2.0 and the Newcastle-Ottawa Scale were used for RCTs and nonrandomized trials, respectively. All data were abstracted by two independent reviewers, with disagreements resolved by a third reviewer.
Of 2115 studies identified in the search, four met criteria for inclusion. Two studies were randomized controlled trials and two were nonrandomized trials. All four studies found positive effects of their intervention on caregiver outcomes of interest, and three out of four studies found statistically significant improvements in key outcomes for caregivers receiving visit information. Improved outcomes included caregiver happiness, caregiver activation, caregiver preparedness, and caregiver confidence in managing patient health.
Our review suggests that using technology to give a caregiver access to clinical visit information could be beneficial to various caregiver outcomes. There is an urgent need to address the lack of research in this area.
当照顾者无法出席他们所照顾的人的诊所就诊时，患者是诊所就诊信息的主要来源；然而，患者的回忆能力较差会影响所分享信息的质量，导致照顾者准备不足，并导致照顾者发病。存在一些技术解决方案来共享诊所就诊信息，但它们的效果尚不清楚。
评估在照顾者无法亲自出席时，技术是否以及如何用于将非正式照顾者与患者的诊所就诊信息联系起来，以及其对照顾者和患者结果的影响。
通过 5/3/2020 在 MEDLINE、Cochrane、Scopus 和 CINAHL 进行了无语言限制或限制的搜索。还包括 ClinicalTrials.gov 和其他参考文献列表。纳入了使用技术媒介（例如视频或电子健康记录）将就诊信息传达给未出席的照顾者的随机对照试验 (RCT) 和非随机试验。使用标准化的数据收集表收集和筛选数据。Cochrane 的风险偏倚 2.0 和纽卡斯尔-渥太华量表分别用于 RCT 和非随机试验。所有数据均由两名独立审查员摘录，意见分歧由第三名审查员解决。
在搜索中确定的 2115 项研究中，有四项符合纳入标准。两项研究为随机对照试验，两项为非随机试验。四项研究均发现其干预措施对照顾者相关结局有积极影响，四项研究中有三项研究发现接受就诊信息的照顾者的关键结局有统计学意义的改善。改善的结局包括照顾者的幸福感、照顾者的积极性、照顾者的准备情况以及照顾者管理患者健康的信心。
我们的综述表明，使用技术让照顾者获得临床就诊信息可能对各种照顾者结局有益。该领域迫切需要开展研究。
