Bell Joshua, Gottlieb Laura M, Lyles Courtney R, Nguyen Oanh Kieu, Ackerman Sara L, De Marchis Emilia H
Department of Pediatrics, University of California, San Francisco, CA, United States.
Department of Family & Community Medicine, University of California, San Francisco, CA, United States.
Front Digit Health. 2024 Jul 29;6:1408170. doi: 10.3389/fdgth.2024.1408170. eCollection 2024.
The COVID-19 pandemic led to a dramatic increase in telemedicine use for direct patient care. Inequities in device/internet access can limit the extent to which patients can engage with telemedicine care and exacerbate health disparities. In this review, we examined existing literature on interventions designed to improve patient telemedicine access by providing digital devices including tablets, smartphones, and computers and/or internet connectivity.
In this systematic scoping review, we searched four databases for peer-reviewed studies published 1/1/2000-10/19/2021 that described healthcare interventions that provided patients with devices and/or internet connectivity and reported outcomes related to telemedicine access and/or usage. Data extraction elements included: study population, setting, intervention design, details on device/connectivity provision, and outcomes evaluated.
Twelve articles reflecting seven unique interventions met inclusion criteria. Ten articles examined telemedicine utilization (83%) and reported improved patient show rates/utilization. Seven articles examined patient satisfaction with the interventions (58%) and reported positive experiences. Fewer articles examined health outcomes (17%; 2/12) though these also demonstrated positive results. Across included studies, study quality was low. There were no controlled trials, and the most rigorously designed studies ( = 4) involved pre/post-intervention assessments.
Findings from this review indicate that providing material technology supports to patients can facilitate telemedicine access, is acceptable to patients and clinicians, and can contribute to improved health outcomes. The low number and quality of existing studies limits the strength of this evidence. Future research should explore interventions that can increase equitable access to telemedicine services.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=183442, identifier, PROSPERO: CRD42020183442.
新冠疫情导致远程医疗在直接患者护理中的使用大幅增加。设备/互联网接入方面的不平等可能会限制患者参与远程医疗护理的程度，并加剧健康差距。在本综述中，我们研究了现有文献中关于通过提供包括平板电脑、智能手机和计算机在内的数字设备和/或互联网连接来改善患者远程医疗接入的干预措施。
在这项系统的范围综述中，我们在四个数据库中搜索了2000年1月1日至2021年10月19日发表的同行评审研究，这些研究描述了为患者提供设备和/或互联网连接的医疗保健干预措施，并报告了与远程医疗接入和/或使用相关的结果。数据提取要素包括：研究人群、环境、干预设计、设备/连接提供的详细信息以及评估的结果。
反映七种独特干预措施的12篇文章符合纳入标准。10篇文章研究了远程医疗的使用情况（83%），并报告患者就诊率/使用率有所提高。7篇文章研究了患者对干预措施的满意度（58%），并报告了积极的体验。较少文章研究了健康结果（17%；12篇中的2篇），不过这些研究也显示出积极结果。在所纳入的研究中，研究质量较低。没有对照试验，设计最严谨的研究（n = 4）涉及干预前后评估。
本综述的结果表明，为患者提供物质技术支持可以促进远程医疗接入，患者和临床医生都可以接受，并且有助于改善健康结果。现有研究的数量和质量较低，限制了这一证据的力度。未来的研究应探索能够增加远程医疗服务公平可及性的干预措施。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=183442，标识符，PROSPERO：CRD42020183442。
