Telemedicine in rheumatology care: A systematic review

被引:23
作者
Jackson, Lesley E. [1 ]
Edgil, Timothy A. [2 ]
Hill, Brittany [3 ]
Owensby, Justin K. [1 ]
Smith, Catherine H. [4 ]
Singh, Jasvinder A. [1 ,5 ,6 ]
Danila, Maria, I [1 ,5 ]
机构
[1] Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Div Gen Internal Med, Birmingham, AL 35294 USA
[3] Brookwood Baptist Hlth, Dept Internal Med, Birmingham, AL USA
[4] Univ Alabama Birmingham, Lister Hill Lib Hlth Sci, Birmingham, AL 35294 USA
[5] Birmingham VA Med Ctr, Geriatr Res Educ & Clin Ctr, Birmingham, AL USA
[6] UAB Sch Publ Hlth, Dept Epidemiol, Birmingham, AL USA
基金
美国国家卫生研究院;
关键词
Telemedicine; Rheumatology; Patient-reported outcomes; Quality of life; Access to care; FACE-TO-FACE; DIGITAL DIVIDE; HEALTH-CARE; ARTHRITIS; TELERHEUMATOLOGY; TECHNOLOGY; COVID-19; PROGRAM;
D O I
10.1016/j.semarthrit.2022.152045
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The COVID-19 pandemic led to a sudden uptake of telemedicine in rheumatology. We analyzed the recent published literature on telemedicine for the diagnosis and management of inflammatory, noninflammatory and/or autoimmune rheumatic diseases. Methods: We performed a registered systematic search (CRD42020202063) for interventional or observational studies published between August 2015 and January 2022. We included studies of telemedicine that reported outcomes (e.g., satisfaction, disease activity, quality of life) in ten or more people with rheumatic disease. Reviewers screened manuscripts, extracted data, and assessed bias. Results: Of the 2,988 potentially eligible studies, 36 reports were included: 27 observational studies, 7 randomized clinical trials, and 2 controlled clinical trials. Studies focused on general rheumatology (n = 18), rheumatoid arthritis (n = 9), gout (n = 3), osteoarthritis (n = 2), unspecified inflammatory arthritis (n = 1), osteoporosis (n = 2), and systemic lupus erythematosus (n = 1). Patient satisfaction with telemedicine was the most common reported outcome (n = 23) with majority of studies demonstrating high levels of satisfaction. Among interventional studies, the effect of telemedicine on the primary outcomes varied, with most finding that telemedicine was as good as usual / in-person care for disease activity control, patient satisfaction, total societal costs, and other patient reported outcomes. Effectiveness and feasibility were high across studies, though most demonstrated a high risk of bias. Meta-analysis was not feasible given the heterogeneity of interventions and outcome instruments utilized. Conclusion: Although the number of studies to date is low, telemedicine may be an effective mode to deliver care for people with rheumatic diseases. Most studies demonstrated limitations due to study design and risk of bias. Randomized clinical studies are needed to determine best uses of telemedicine for the diagnosis and management of rheumatic conditions.
引用
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页数:17
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