Albritton Jordan A, Booth Graham, Kugley Shannon, Reddy Shivani, Coker-Schwimmer Manny, Fujita Miku, Crotty Karen
RTI International, Research Triangle Park, NC.
The Ohio State University, Columbus, OH.
Med Care. 2025 Feb 1;63(2):164-182. doi: 10.1097/MLR.0000000000002097. Epub 2025 Jan 9.
There is a lack of consensus on the effectiveness of audio-based care to manage chronic conditions. This knowledge gap has implications for health policy decisions and for health equity, as underserved populations are more likely to access care by telephone.
We compared the effectiveness of audio-based care to usual care for managing chronic conditions (except diabetes).
We used systematic review methods to synthesize available evidence.
We searched for English-language articles reporting on randomized controlled trials (RCTs) of adults diagnosed with a chronic condition published since 2012.
We abstracted data on clinical outcomes, patient-reported health and quality of life, health care access and utilization, care quality and experience, and patient safety.
We included 40 RCTs evaluating audio-based care for a variety of chronic conditions, including cancer, heart failure, neurological disease, respiratory disease, musculoskeletal conditions, kidney disease, and others. There was significant heterogeneity across conditions and interventions. We generally found low to very low certainty of evidence of comparable effectiveness in the use of audio-based care to replace other care. Audio care as a supplement exhibited greater effectiveness in some outcomes, with generally low to very low certainty of evidence for most outcomes but moderate certainty for 2 groups of study outcomes.
More research is needed to identify the conditions, populations, and intervention design combinations that improve outcomes and to determine when audio-based care can effectively replace other synchronous care.
对于基于音频的护理在慢性病管理中的有效性，目前尚无共识。这一知识空白对卫生政策决策和卫生公平性具有影响，因为服务不足的人群更有可能通过电话获得护理服务。
我们比较了基于音频的护理与常规护理在慢性病（糖尿病除外）管理中的有效性。
我们采用系统评价方法来综合现有证据。
我们检索了自2012年以来发表的关于诊断为慢性病的成年人随机对照试验（RCT）的英文文章。
我们纳入了40项评估基于音频的护理对各种慢性病（包括癌症、心力衰竭、神经系统疾病、呼吸系统疾病、肌肉骨骼疾病、肾脏疾病等）有效性的随机对照试验。不同疾病和干预措施之间存在显著异质性。我们总体上发现，在使用基于音频的护理替代其他护理方面，证据的确定性从低到极低。作为补充的音频护理在某些结果方面表现出更大的有效性，大多数结果的证据确定性通常从低到极低，但两组研究结果的证据确定性为中等。
需要更多的研究来确定能够改善结果的疾病、人群和干预设计组合，并确定基于音频的护理何时能够有效替代其他同步护理。
