Leclercq Victoria, Vandervliet Léopold, Schmitt Tugce, Van den Bulcke Marc, Delnord Marie
Cancer Centre, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Front Public Health. 2025 May 22;13:1483706. doi: 10.3389/fpubh.2025.1483706. eCollection 2025.
Over the last few years, telemedicine (TM) services have increasingly been used in European health and care systems. TM services include remote assistance with teleconsultation and telemonitoring. Several sources highlight that TM services may widen existing inequities in health. Therefore, this study aimed to identify barriers and facilitators contributing to inequities to TM among cancer patients in Europe.
Medline (via Ovid) and Scopus databases were searched for all publications providing evidence on factors influencing the access to and use of TMs among cancer patients aged 18 and over in Europe published between January 2018 and March 2023. The PROGRESS-plus framework was used to map health equity factors in TM services among cancer patients.
A total of 2072 peer reviewed publications were identified and after screening, 26 articles were retained in our scoping review. Only studies focused on TM used by cancer patients through mobile or web-based applications were included. In terms of access to TM, people with lower socioeconomic status, including difficulties with having an internet connection and not having their own mobile device, and language barrier seem to have less access to TM services. For the use of TM services, a lower level of education, few digital skills and (e-)health literacy, lack of social support, age and presence of comorbidities are important determinants.
Better integration of patient needs in TM is necessary to enhance equity and allow a better implementation of TMs in European health and care systems aligned with different initiatives such European Beating Cancer Plan.
在过去几年中，远程医疗（TM）服务在欧洲的卫生和保健系统中使用得越来越频繁。TM服务包括远程会诊和远程监测的远程协助。一些资料强调，TM服务可能会扩大现有的健康不平等现象。因此，本研究旨在确定导致欧洲癌症患者在使用TM方面存在不平等现象的障碍和促进因素。
检索了Medline（通过Ovid）和Scopus数据库，查找2018年1月至2023年3月期间发表的所有关于影响欧洲18岁及以上癌症患者获取和使用TM的因素的出版物。采用PROGRESS-plus框架来梳理癌症患者TM服务中的健康公平因素。
共识别出2072篇同行评议出版物，经过筛选，26篇文章被纳入我们的范围综述。仅纳入了关注癌症患者通过移动或基于网络的应用程序使用TM的研究。在获取TM方面，社会经济地位较低者，包括存在互联网连接困难和没有自己的移动设备，以及语言障碍，似乎获得TM服务的机会较少。对于TM服务的使用，教育水平较低、数字技能和（电子）健康素养较少、缺乏社会支持、年龄以及合并症的存在是重要的决定因素。
有必要更好地将患者需求融入TM，以提高公平性，并使TM在欧洲卫生和保健系统中更好地实施，与诸如欧洲抗癌计划等不同倡议保持一致。
