Taher Do Alfuqhar Iman Mohammed, Ali Khalafalla Alaa Eldirdiri, Mahmoud Ali Salma Hassan, Aydaross Adam Elwaleed Idrees, Osman Hanady M, Safar Alrabie Rwabi
General Practice, Primary Health Care Center, Emirates Health Services (EHS), Dubai, ARE.
Pediatrics, Hull University Teaching Hospitals NHS Trust, Hull Royal Infirmary, Hull, GBR.
Cureus. 2024 Oct 22;16(10):e72144. doi: 10.7759/cureus.72144. eCollection 2024 Oct.
Healthcare delivery is made more convenient and effective via telemedicine, which enables physicians to conduct virtual consultations and evaluations with pediatric patients. The purpose of this systematic review was to evaluate the efficacy of telemedicine as compared to physical appointments in the pediatric population. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search for the available literature using pre-specified inclusion and exclusion criteria. These databases provided 968 relevant research articles, which Endnote software screened for duplicates. Fourteen studies were considered relevant for full-text evaluation. After complete text evaluation, only 11 of these articles were found to be relevant. The Newcastle-Ottawa Scale (NOS) was used for the risk of bias assessment of all included studies. Eleven articles in all satisfied the requirements for inclusion and were added to the review. Every study was classified as either a cluster randomized trial (27%) or a randomized controlled trial (RCT) (73%). There were between 22 and 400 participants in each trial. Medical conditions evaluated included obesity (27%), mental health disorders (9%), asthma (18%), otitis media (9%), skin disorders (9%), type 1 diabetes (9%), attention deficit hyperactivity disorder (ADHD) (9%), and pancreatic insufficiency associated with cystic fibrosis (1/11). Telemedicine strategies employed included telemedicine-based screening visits (9%), smartphone-based therapies (27%), phone counseling (18%), and videoconferencing visits between patients and doctors (45%). The outcomes of the telemedicine procedures in every included study were on par with or superior to those of the control groups. Medication adherence, appointment completion rates, life satisfaction, symptom management, and disease progression were all outcomes associated with these findings. Although more research is needed, the evidence from this review suggests that telemedicine services for the general public and pediatric care are comparable to or better than in-person services. Patients, healthcare professionals, and caregivers may benefit from using both telemedicine services and traditional in-person healthcare services. To maximize the potential of telemedicine, future research should focus on improving patients' access to care, increasing the cost-effectiveness of telemedicine services, and eliminating barriers to telemedicine use.
通过远程医疗，医疗服务变得更加便捷有效，这使医生能够与儿科患者进行虚拟会诊和评估。本系统评价的目的是评估远程医疗与儿科患者面对面预约相比的疗效。我们使用系统评价和Meta分析的首选报告项目（PRISMA）指南，根据预先指定的纳入和排除标准搜索可用文献。这些数据库提供了968篇相关研究文章，Endnote软件对其进行了重复筛选。14项研究被认为与全文评估相关。经过全文评估，发现其中只有11篇文章相关。纽卡斯尔-渥太华量表（NOS）用于对所有纳入研究的偏倚风险进行评估。总共有11篇文章符合纳入要求并被纳入综述。每项研究要么被归类为整群随机试验（27%），要么被归类为随机对照试验（RCT）（73%）。每项试验的参与者人数在22至400人之间。评估的医疗状况包括肥胖（27%）、精神健康障碍（9%）、哮喘（18%）、中耳炎（9%）、皮肤病（9%）、1型糖尿病（9%）、注意力缺陷多动障碍（ADHD）（9%）以及与囊性纤维化相关的胰腺功能不全（1/11）。采用的远程医疗策略包括基于远程医疗的筛查就诊（9%）、基于智能手机的治疗（27%）、电话咨询（18%）以及患者与医生之间的视频会议就诊（45%）。每项纳入研究中远程医疗程序的结果与对照组相当或优于对照组。药物依从性、预约完成率、生活满意度、症状管理和疾病进展都是与这些结果相关的指标。尽管还需要更多研究，但本次综述的证据表明，面向公众和儿科护理的远程医疗服务与面对面服务相当或更好。患者、医疗保健专业人员和护理人员可能会从使用远程医疗服务和传统的面对面医疗服务中受益。为了最大限度地发挥远程医疗的潜力，未来的研究应侧重于改善患者获得医疗服务的机会、提高远程医疗服务的成本效益以及消除远程医疗使用的障碍。
