Smith Anthony, Innes Sue
School of Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom.
PLOS Digit Health. 2025 Mar 31;4(3):e0000789. doi: 10.1371/journal.pdig.0000789. eCollection 2025 Mar.
Telehealth has been at the forefront of healthcare delivery since the Covid-19 pandemic with a prompt shift in transition from face-to-face delivery to remote contact. This critical review aims to understand patient and clinician views of telehealth adoption regarding effectiveness and satisfaction within musculoskeletal (MSK) physiotherapy services. A systematic process was used to search for evidence within 6 databases (CINAHL, PyscINFO, Medline, AMED, EMCARE, EMBASE) utilising clear inclusion and exclusion criteria in August 2024. Articles published in English between 2019-2024 were searched, a total of 394 articles were identified and 10 articles were included in the review. Methodological quality was evaluated using the CASP, JBI and QuADS tools. Findings were evaluated via consensus and showed clear patient and clinician satisfaction with positive themes of reduced travel, reduced physical burden, flexibility/accessibility and negative themes of reduced physical contact, computer literacy and privacy infringements. Quality analysis identified non-response bias, sampling bias, and participants mix as risks to overall validity. Telehealth has shown to be an effective and transformative model of healthcare delivery for musculoskeletal services, especially in improving access and convenience for patients. Implications for practice suggest a need for a hybrid model of care, enhanced training, and improved data security. Future research should focus on satisfaction within condition specific musculoskeletal health, overall cost-effectiveness, health equity, and the integration of advanced technologies to ensure telehealth can be a sustainable and inclusive part of the healthcare landscape moving forwards.
自新冠疫情以来，远程医疗一直处于医疗服务的前沿，迅速从面对面服务转向远程接触。本综述旨在了解患者和临床医生对在肌肉骨骼（MSK）物理治疗服务中采用远程医疗的有效性和满意度的看法。2024年8月，我们采用系统的流程，利用明确的纳入和排除标准，在6个数据库（CINAHL、PyscINFO、Medline、AMED、EMCARE、EMBASE）中搜索证据。搜索了2019年至2024年期间发表的英文文章，共识别出394篇文章，其中10篇文章被纳入综述。使用CASP、JBI和QuADS工具评估方法学质量。通过共识对研究结果进行评估，结果显示患者和临床医生明确表示满意，其中积极的方面包括出行减少、身体负担减轻、灵活性/可及性提高，消极的方面包括身体接触减少、计算机素养要求和隐私侵犯。质量分析确定无应答偏倚、抽样偏倚和参与者构成是影响整体有效性的风险因素。远程医疗已被证明是肌肉骨骼服务中一种有效且具有变革性的医疗服务模式，特别是在改善患者的可及性和便利性方面。对实践的启示表明需要采用混合护理模式、加强培训并改善数据安全。未来的研究应关注特定肌肉骨骼疾病患者的满意度、总体成本效益、健康公平性以及先进技术的整合，以确保远程医疗能够成为未来医疗格局中可持续且包容的一部分。
