Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Int J Impot Res. 2022 Nov;34(7):663-668. doi: 10.1038/s41443-021-00498-5. Epub 2021 Nov 19.
The events of the 2019 SARS-CoV2 virus pandemic have all but ensured that telemedicine will remain an important aspect of patient care delivery. As health technologies evolve, so must physician practices. Currently, there is limited data on the management of testosterone replacement therapy (TRT) in the era of telemedicine. This review aims to explore the potential benefits and pitfalls of TRT management via telemedicine. We also propose a theoretical framework for TRT management via telemedicine. Telemedicine provides patients and physicians with a new mechanism for American Urological Association guideline-concordant TRT management that can increase patient access to care and provide a safe space for men who may otherwise not have been comfortable with in-person evaluation. However, there are significant limitations to the use of telemedicine for the management of TRT, including the inability to perform a physical exam, inability to administer specific medications, technological barriers, data security, and medical-legal considerations, and both patients and providers should engage in shared decision making before pursuing this approach. Understanding and acknowledging the potential pitfalls of telemedicine for TRT management will enable both patients and providers to achieve optimal outcomes and satisfaction.
2019 年 SARS-CoV2 病毒大流行的事件几乎可以肯定,远程医疗将仍然是患者护理提供的一个重要方面。随着医疗技术的发展,医生的实践也必须随之改变。目前,关于远程医疗时代睾酮替代疗法 (TRT) 的管理的数据有限。本综述旨在探讨通过远程医疗管理 TRT 的潜在益处和陷阱。我们还提出了通过远程医疗管理 TRT 的理论框架。远程医疗为患者和医生提供了一种新的机制,使美国泌尿外科学会指南一致的 TRT 管理,这可以增加患者获得护理的机会,并为那些可能不喜欢亲自评估的男性提供一个安全的空间。然而,远程医疗在 TRT 管理中的使用存在重大限制,包括无法进行身体检查、无法使用特定药物、技术障碍、数据安全和医疗法律考虑因素,并且在采用这种方法之前,患者和提供者都应该进行共同决策。了解和承认远程医疗在 TRT 管理方面的潜在陷阱将使患者和提供者能够实现最佳的结果和满意度。