Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK.
Health Soc Care Deliv Res. 2023 Nov;11(22):1-74. doi: 10.3310/BVCF6192.
Remote monitoring involves the measurement of an aspect of a patient's health without that person being seen face to face. It could benefit the individual and aid the efficient provision of health services. However, remote monitoring can be used to monitor different aspects of health in different ways. This evidence map allows users to find evidence on different forms of remote monitoring for different conditions easily to support the commissioning and implementation of interventions.
The aim of this map was to provide an overview of the volume, diversity and nature of recent systematic reviews on the effectiveness, acceptability and implementation of remote monitoring for adults with long-term physical health conditions.
We searched MEDLINE, nine further databases and Epistemonikos for systematic reviews published between 2018 and March 2022, PROSPERO for continuing reviews, and completed citation chasing on included studies.
(Study selection and Study appraisal): Included systematic reviews focused on adult populations with a long-term physical health condition and reported on the effectiveness, acceptability or implementation of remote monitoring. All forms of remote monitoring where data were passed to a healthcare professional as part of the intervention were included. Data were extracted on the characteristics of the remote monitoring intervention and outcomes assessed in the review. AMSTAR 2 was used to assess quality. Results were presented in an interactive evidence and gap map and summarised narratively. Stakeholder and public and patient involvement groups provided feedback throughout the project.
We included 72 systematic reviews. Of these, 61 focus on the effectiveness of remote monitoring and 24 on its acceptability and/or implementation, with some reviews reporting on both. The majority contained studies from North America and Europe (38 included studies from the United Kingdom). Patients with cardiovascular disease, diabetes and respiratory conditions were the most studied populations. Data were collected predominantly using common devices such as blood pressure monitors and transmitted via applications, websites, e-mail or patient portals, feedback provided via telephone call and by nurses. In terms of outcomes, most reviews focused on physical health, mental health and well-being, health service use, acceptability or implementation. Few reviews reported on less common conditions or on the views of carers or healthcare professionals. Most reviews were of low or critically low quality.
Many terms are used to describe remote monitoring; we searched as widely as possible but may have missed some relevant reviews. Poor reporting of remote monitoring interventions may mean some included reviews contain interventions that do not meet our definition, while relevant reviews might have been excluded. This also made the interpretation of results difficult.
The map provides an interactive, visual representation of evidence on the effectiveness of remote monitoring and its acceptability and successful implementation. This evidence could support the commissioning and delivery of remote monitoring interventions, while the limitations and gaps could inform further research and technological development. Future reviews should follow the guidelines for conducting and reporting systematic reviews and investigate the application of remote monitoring in less common conditions.
A protocol was registered on the OSF registry (https://doi.org/10.17605/OSF.IO/6Q7P4).
This award was funded by the National Institute for Health and Care Research (NIHR) Health Services and Delivery Research programme (NIHR award ref: NIHR135450) as part of a series of evidence syntheses under award NIHR130538. For more information, visit https://fundingawards.nihr.ac.uk/award/NIHR135450 and https://fundingawards.nihr.ac.uk/award/NIHR130538. The report is published in full in ; Vol. 11, No. 22. See the NIHR Funding and Awards website for further project information.
远程监测是指在患者未面对面就诊的情况下对其健康状况进行的某方面的测量。它可以使个人受益，并有助于提高卫生服务的效率。但是，远程监测可以用于以不同的方式监测健康的不同方面。本证据图谱使使用者能够轻松找到针对不同条件的不同形式远程监测的证据，以支持干预措施的委托和实施。
本图谱旨在提供对 2018 年至 2022 年 3 月期间发表的关于成人长期身体健康状况下远程监测的有效性、可接受性和实施情况的系统评价的数量、多样性和性质的概述。
我们在 MEDLINE、其他九个数据库和 Epistemonikos 中搜索了 2018 年至 2022 年 3 月期间发表的系统评价，在 PROSPERO 中搜索了正在进行的评价，并对纳入的研究进行了文献追溯。
纳入的系统评价侧重于成年人群体，患有长期身体健康状况，并报告了远程监测的有效性、可接受性或实施情况。所有将数据传递给医疗保健专业人员作为干预措施一部分的远程监测形式都包括在内。对远程监测干预措施的特征和评价中评估的结果进行了数据提取。使用 AMSTAR 2 评估质量。结果以互动证据和差距图谱的形式呈现，并以叙述的方式进行总结。利益相关者和公众和患者参与团体在整个项目中提供了反馈。
我们纳入了 72 项系统评价。其中，61 项重点关注远程监测的有效性，24 项关注其可接受性和/或实施情况，一些评价报告了两者。大多数评价包含来自北美和欧洲的研究（英国的 38 项研究）。心血管疾病、糖尿病和呼吸系统疾病患者是研究最多的人群。数据主要使用常见设备收集，如血压监测仪，并通过应用程序、网站、电子邮件或患者门户传输，通过电话和护士提供反馈。就结果而言，大多数评价都集中在身体健康、心理健康和幸福感、卫生服务使用、可接受性或实施情况上。很少有评价报告了不太常见的情况或护理人员或医疗保健专业人员的意见。大多数评价的质量为低或极低级。
许多术语用于描述远程监测；我们尽可能广泛地进行了搜索，但可能遗漏了一些相关的评价。远程监测干预措施的报告不佳可能意味着一些纳入的评价包含不符合我们定义的干预措施，而相关的评价可能被排除在外。这也使得结果的解释变得困难。
该图谱提供了一个关于远程监测有效性及其可接受性和成功实施的证据的互动、可视化表示。该证据可以支持远程监测干预措施的委托和交付，而局限性和差距可以为进一步的研究和技术发展提供信息。未来的评价应遵循系统评价的指南，并调查远程监测在较不常见情况下的应用。
该方案在 OSF 注册处（https://doi.org/10.17605/OSF.IO/6Q7P4）注册。
该奖项由英国国家卫生与保健研究所（NIHR）卫生服务和交付研究计划（NIHR 奖项参考：NIHR135450）资助，作为该系列证据综合的一部分，该系列由 NIHR130538 资助。欲了解更多信息，请访问 https://fundingawards.nihr.ac.uk/award/NIHR135450 和 https://fundingawards.nihr.ac.uk/award/NIHR130538。报告全文发表在 ; 第 11 卷，第 22 期。有关该项目的更多信息，请访问 NIHR 资助和奖项网站。
