Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, Australia; South West Sydney Clinical Campuses, University of New South Wales, Liverpool, NSW, Australia.
Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, Australia; South West Sydney Clinical Campuses, University of New South Wales, Liverpool, NSW, Australia.
Crit Rev Oncol Hematol. 2022 Dec;180:103869. doi: 10.1016/j.critrevonc.2022.103869. Epub 2022 Nov 7.
Telehealth facilitates access to cancer care for patients unable to attend in-person consultations, as in COVID-19. This systematic review used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to evaluate telehealth implementation and examine enablers and barriers to optimal implementation in oncology. MEDLINE, PubMed, CINAHL, and the Cochrane Database of Systematic Reviews were searched between January 2011-June 2022. Eighty-two articles representing 73 studies were included. One study explicitly used the RE-AIM framework to guide study design, conduct, or reporting. Reach (44%) and implementation (38%) were most commonly reported, maintenance (5%) least commonly. Key telehealth implementation enablers included professional-led delivery, patient-centred approaches, and positive patient perceptions. Key barriers included patient discomfort with technology, limited supporting clinic infrastructure, and poor access to reliable internet connection and videoconferencing. While a patient-centred and professional-supported approach enables telehealth implementation, technology and infrastructure constraints need surmounting for sustained implementation beyond the COVID-19 pandemic.
远程医疗为无法进行面对面咨询的癌症患者提供了获得癌症治疗的机会，例如在 COVID-19 大流行期间。本系统评价使用了可达性、有效性、采用、实施和维持（RE-AIM）框架来评估远程医疗的实施情况，并研究了在肿瘤学中实现最佳实施的促进因素和障碍。在 2011 年 1 月至 2022 年 6 月期间，对 MEDLINE、PubMed、CINAHL 和 Cochrane 系统评价数据库进行了搜索。共有 82 篇文章代表 73 项研究被纳入。仅有一项研究明确使用了 RE-AIM 框架来指导研究设计、进行或报告。最常报告的是可达性（44%）和实施（38%），维护（5%）则最少。关键的远程医疗实施促进因素包括专业人员主导的交付、以患者为中心的方法和积极的患者认知。关键障碍包括患者对技术的不适应、有限的支持诊所基础设施以及可靠的互联网连接和视频会议的获取有限。虽然以患者为中心和专业人员支持的方法可以实现远程医疗的实施，但需要克服技术和基础设施方面的限制，以便在 COVID-19 大流行之后持续实施。
