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扩大澳大利亚心脏康复服务中远程医疗的可及性:一项关于障碍、促进因素及采用情况的全国性调查

Expanding access to telehealth in Australian cardiac rehabilitation services: a national survey of barriers, enablers, and uptake.

作者信息

Thomas Emma E, Cartledge Susie, Murphy Barbara, Abell Bridget, Gallagher Robyn, Astley Carolyn

机构信息

Centre for Online Health, The University of Queensland, Bldg 33, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland 4103, Australia.

Centre for Health Services Research, The University of Queensland, Bldg 33, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland 4103, Australia.

出版信息

Eur Heart J Digit Health. 2023 Oct 3;5(1):21-29. doi: 10.1093/ehjdh/ztad055. eCollection 2024 Jan.

Abstract

AIMS

Cardiac rehabilitation (CR) is traditionally delivered in-person; however, the COVID-19 pandemic provided impetus for alternative offerings such as telehealth. We investigated uptake, barriers, and enablers in a national survey during the pandemic in Australia.

METHODS AND RESULTS

We surveyed CR programmes between April and June 2021 using professional association networks. The anonymous online questionnaire addressed programme characteristics, COVID-19 impacts, and barriers to and enablers of telehealth use. Open-text responses were coded and presented as themes. In total, there were responses from 105 programmes (33% response rate). All states and geographical areas were represented. The use of every modality of telehealth care (telephone, video conferencing, text messaging, and web-based) increased significantly during and after COVID with a strong preference for telephone (85% of services). Respondents perceived video (53%) and telephone (47%) formats as safe and effective for delivering CR. The most common barriers to telehealth were difficulties conducting assessments and reduced engagement with patients. Prominent enablers were increased reach and reduced patient barriers to CR access.

CONCLUSION

Telehealth use by CR programmes increased during the peak pandemic period. However, additional support is required to ensure that telehealth services can be maintained. There is considerable potential to increase the reach of CR by embedding telehealth into existing models of care.

摘要

目的

心脏康复(CR)传统上是面对面进行的;然而,新冠疫情推动了远程医疗等替代服务的发展。我们在澳大利亚疫情期间的一项全国性调查中研究了远程医疗的使用情况、障碍和促进因素。

方法与结果

我们在2021年4月至6月期间通过专业协会网络对心脏康复项目进行了调查。匿名在线问卷涉及项目特征、新冠疫情的影响以及远程医疗使用的障碍和促进因素。对开放式文本回复进行编码并呈现为主题。共有105个项目做出了回复(回复率为33%)。所有州和地理区域均有代表。在新冠疫情期间及之后,各种远程医疗模式(电话、视频会议、短信和基于网络的模式)的使用显著增加,其中对电话模式的偏好强烈(85%的服务)。受访者认为视频(53%)和电话(47%)模式在提供心脏康复方面安全有效。远程医疗最常见的障碍是进行评估困难以及与患者的互动减少。突出的促进因素是覆盖面扩大以及患者获得心脏康复的障碍减少。

结论

在疫情高峰期,心脏康复项目对远程医疗的使用有所增加。然而,需要额外的支持以确保远程医疗服务能够持续。通过将远程医疗融入现有护理模式,扩大心脏康复覆盖面具有相当大的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1a9/10802819/2b837559d45c/ztad055_ga1.jpg

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