BMed, MD, FRACGP, Academic General Practice Registrar, Graduate School of Medicine, University of Wollongong, NSW; Conjoint Lecturer, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW; General Practitioner and Integrated Care Clinical Lead, MQ Health, Macquarie University, NSW.
BPsych (Hons), PhD, Postdoctoral Research Fellow, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW.
Aust J Gen Pract. 2024 Nov-Supplement;53(11 Suppl):S107-S114. doi: 10.31128/AJGP-12-23-7070.
This study comprehensively reviews the contemporary empirical literature on direct-to-consumer (DTC) telemedicine services within primary care.
MEDLINE, Embase and SCOPUS were strategically searched and screened. Data on the modality of consultations, population of focus, condition of focus and treatment of focus were extracted, narratively synthesised and tabulated.
Forty-four articles were included in this review. Most used quantitative methods, with predominantly cross-sectional or retrospective cohort designs. DTC telemedicine user characteristics and perspectives were most researched, followed by quality and safety. Most services used video or text messaging. Articles typically examined a specific health condition (eg acute respiratory infections) and its treatment, and several focused on a specific population (eg men).
In light of the poor evidence base and lack of rigorous studies, there is a critical need for more robust research on DTC telemedicine within primary care. Quality assessment tool development and health economics analyses are necessary to support the integratation of DTC telemedicine services with traditional primary care systems and improve primary healthcare quality and efficiency.
本研究全面回顾了初级保健中直接面向消费者（DTC）远程医疗服务的当代实证文献。
通过策略性搜索和筛选 MEDLINE、Embase 和 SCOPUS。提取咨询模式、关注人群、关注疾病和关注治疗的数据，进行叙述性综合和制表。
本综述纳入了 44 篇文章。大多数研究使用定量方法，主要是横断面或回顾性队列设计。DTC 远程医疗用户特征和观点的研究最多，其次是质量和安全性。大多数服务使用视频或短信。文章通常研究特定的健康状况（例如急性呼吸道感染）及其治疗，还有一些专注于特定人群（例如男性）。
鉴于证据基础较差且缺乏严格的研究，迫切需要对初级保健中的 DTC 远程医疗进行更有力的研究。需要开发质量评估工具和健康经济学分析，以支持 DTC 远程医疗服务与传统初级保健系统的整合，并提高初级医疗保健的质量和效率。
