Hinman Rana S, Lawford Belinda J, Nelligan Rachel K, Bennell Kim L
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, VIC Australia.
Curr Treatm Opt Rheumatol. 2023 Mar 11:1-21. doi: 10.1007/s40674-023-00202-2.
There is increasing recognition that virtual tools, enabled by the internet and telecommunications technology, can increase access to health care. We review evidence about the clinical effectiveness and acceptability of telephone-delivered and videoconferencing clinician consultations, websites and internet-delivered programs, and SMS and mobile applications in enabling the management of people with knee osteoarthritis (OA). We discuss barriers to using virtual tools and suggest strategies to facilitate implementation in clinical settings.
An increasing number of systematic reviews, meta-analyses, and clinical trials provide evidence showing the effectiveness of virtual tools for improving knee OA management. Qualitative research shows that virtual tools increase patient access to knee OA care, are generally acceptable and convenient for patients, but can be associated with barriers to use from patient and clinician perspectives.
Virtual tools offer new opportunities to enable people with knee OA to manage their condition and receive care that may otherwise be difficult or not possible to access. Telephone calls and videoconferencing can be used for real-time synchronous consultations between clinicians and patients, increasing the geographic reach of health services. Websites and internet-based programs can be used to educate patients about their condition, as well as deliver exercise, weight management, and psychological interventions. Mobile apps can monitor and track OA symptoms, exercise, and physical activity, while SMS can facilitate positive behaviour changes for self-management over the long-term when sustained clinician contact may not be possible.
人们越来越认识到，借助互联网和电信技术的虚拟工具可以增加获得医疗保健的机会。我们回顾了有关通过电话和视频会议进行临床医生咨询、网站和基于互联网的项目，以及短信和移动应用程序在膝关节骨关节炎（OA）患者管理中的临床有效性和可接受性的证据。我们讨论了使用虚拟工具的障碍，并提出了在临床环境中促进其实施的策略。
越来越多的系统评价、荟萃分析和临床试验提供的证据表明，虚拟工具在改善膝关节OA管理方面是有效的。定性研究表明，虚拟工具增加了患者获得膝关节OA护理的机会，对患者来说通常是可接受且方便的，但从患者和临床医生的角度来看，可能存在使用障碍。
虚拟工具为膝关节OA患者管理病情和接受护理提供了新机会，否则这些护理可能难以获得或无法获得。电话和视频会议可用于临床医生与患者之间的实时同步咨询，扩大医疗服务的地理覆盖范围。网站和基于互联网的项目可用于对患者进行病情教育，以及提供运动、体重管理和心理干预。移动应用程序可以监测和跟踪OA症状、运动和身体活动，而短信可以在长期无法持续与临床医生联系时，促进积极的行为改变以实现自我管理。
