The impact of telehealth in sepsis care: A systematic review

被引:4
作者
Tu, Kevin J. [1 ]
Wymore, Cole [2 ]
Tchangalova, Nedelina [3 ]
Fuller, Brian M. [4 ]
Mohr, Nicholas M. [5 ,6 ,7 ]
机构
[1] Univ Maryland, Dept Cell Biol & Mol Genet, College Pk, MD USA
[2] Univ Iowa, Carver Coll Med, Dept Emergency Med, Iowa City, IA USA
[3] Univ Maryland Lib, Res & Acad Serv, College Pk, MD USA
[4] Washington Univ, Sch Med, Dept Anesthesiol, Dept Emergency Med,Div Crit Care, St Louis, MO USA
[5] Univ Iowa, Carver Coll Med, Dept Emergency Med, 200 Hawkins Dr,1008 RCP, Iowa City, IA 52242 USA
[6] Univ Iowa, Carver Coll Med, Dept Anesthesia Crit Care, 200 Hawkins Dr,1008 RCP, Iowa City, IA 52242 USA
[7] Univ Iowa, Carver Coll Med, Dept Epidemiol, 200 Hawkins Dr,1008 RCP, Iowa City, IA 52242 USA
基金
美国医疗保健研究与质量局;
关键词
Sepsis; telehealth; tele-ICU; tele-ED; survival; systematic review; patient outcomes; processes of care; GOAL-DIRECTED THERAPY; QUALITY-OF-CARE; SEPTIC SHOCK; SURVIVING SEPSIS; EMERGENCY-DEPARTMENT; INTERHOSPITAL TRANSFER; INCREASED MORTALITY; TELEMEDICINE; CAMPAIGN; VOLUME;
D O I
10.1177/1357633X231170038
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives Sepsis is associated with significant mortality. Telehealth may improve the quality of early sepsis care, but the use and impact of telehealth applications for sepsis remain unclear. We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes. Data Sources We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date. Study Selection Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included. Data Extraction and Synthesis Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. A random-effects subgroup analysis was conducted on patient survival treated with and without telehealth. Results A total of 15 studies were included, involving 188,418 patients with sepsis. Thirteen studies used observational study designs, and the most common telehealth applications were provider-to-provider telehealth consultation and intensive care unit telehealth. Clinical and methodological heterogeneity was significantly high. Telehealth use was associated with higher survival, especially in settings with low control group survival. The effect of telehealth on other care processes and outcomes were more varied and likely dependent on hospital-level factors. Conclusions Telehealth has been used in diverse applications for sepsis care, and it may improve patient outcomes in certain contexts. Additional interventional trials and cost-based analyses would clarify the causal role of telehealth in improving sepsis outcomes.
引用
收藏
页码:3 / 13
页数:11
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