Twenty years of telemedicine in chronic disease management – an evidence synthesis

Journal of Telemedicine and Telecare - Tập 18 Số 4 - Trang 211-220 - 2012
Richard Wootton1
1Norwegian Centre for Integrated Care and Telemedicine, Tromsø, Norway

Tóm tắt

A literature review was conducted to obtain a high-level view of the value of telemedicine in the management of five common chronic diseases (asthma, COPD, diabetes, heart failure, hypertension). A total of 141 randomised controlled trials (RCTs) was identified, in which 148 telemedicine interventions of various kinds had been tested in a total of 37,695 patients. The value of each intervention was categorised in terms of the outcomes specified by the investigators in that trial, i.e. no attempt was made to extract a common outcome from all studies, as would be required for a conventional meta-analysis. Summarizing the value of these interventions shows, first, that most studies have reported positive effects ( n = 108), and almost none have reported negative effects ( n = 2). This suggests publication bias. Second, there were no significant differences between the chronic diseases, i.e. telemedicine seems equally effective (or ineffective) in the diseases studied. Third, most studies have been relatively short-term (median duration 6 months). It seems unlikely that in a chronic disease, any intervention can have much effect unless applied for a long period. Finally, there have been very few studies of cost-effectiveness. Thus the evidence base for the value of telemedicine in managing chronic diseases is on the whole weak and contradictory.

Từ khóa


Tài liệu tham khảo

10.1016/S0140-6736(06)68770-9

10.1377/hlthaff.20.6.233

10.1111/j.1365-2702.2009.02900.x

10.1093/intqhc/mzi016

Wootton R, 2003, in Best Practices in the Behavioral Management of Chronic Disease. Vol II Other Medical Disorders

10.1089/tmj.2008.0021

10.1002/14651858.CD007718.pub2

10.1089/tmj.2010.0015

10.1089/tmj.2009.0044

10.1111/j.1365-2753.2010.01536.x

10.1016/j.cardfail.2006.09.001

10.1136/bmj.39156.536968.55

10.1258/jtt.2010.100113

10.1186/1471-2296-10-72

10.1089/tmj.2009.0028

10.1111/j.1464-5491.2005.01627.x

10.1002/14651858.CD007228.pub2

Jaana M, 2009, Am J Manag Care, 15, 313

10.1016/S1388-9842(03)00160-0

10.1258/135763306777889109

10.1002/14651858.CD007717.pub2

10.1111/j.1463-1326.2009.01057.x

10.1258/jtt.2009.090812

10.1258/jtt.2009.090406

10.1089/tmj.2007.0114

10.1186/1687-9856-2010-536957

10.2196/jmir.9.5.e37

10.1177/193229681000400323

10.1158/1078-0432.CCR-08-0325

10.1161/CIRCULATIONAHA.111.018473

10.1056/NEJMoa1010029

10.1136/bmj.d4002

10.1197/jamia.M3157

10.7326/0003-4819-149-8-200810210-00006

Thông tin
Thông tin xuất bản

Journal of Telemedicine and Telecare

Tập 18 Số 4

211-220

Thông tin tác giả