Telemedicine in outpatient care for chronic diseases: a systematic meta-analysis

10.30207/AHLA.202312.0039

Hai Duong；Peter Chang

Chronic disease ； COPD ； diabetes ； heart failure ； inflammatory bowel diseases ； outpatient ； telemedicine

The Proceeding of the 9th AHLA International Health Literacy Conference: Health Literacy and Social Resilience

2023（2023 / 12 / 01）

41 - 41

英文

Background: Telemedicine uses telecommunication technologies and electronic information to provide health care services from a distance. Telemedicine has become increasingly popular recently, allowing real-time medical consultations with medical professionals. A meta-analysis on telemedicine was conducted to review its role in outpatient care for chronic diseases. Objectives: This study aimed to evaluate telemedicine on reducing chronic disease-related hospitalization and clinical outcomes, including mortality, HbA1c, and hypoglycemia in diabetes patients. Methods: Based on designated keywords and subject headings, "Telemedicine" and "Outpatient", studies were searched in Cochrane Library, Embase, PubMed, and Web of Science without language or date limitations. The titles and abstracts were comprehensively screened in EndNote version 20.1 software. Full texts of relevant studies were accessed for meta-analysis. Two authors worked independently with discussion and agreement. Results: Twenty-one studies met inclusion criteria among 3,670 published studies. Diabetes was the most common disease, followed by heart failure. Pooled analysis of 13 of 21 studies showed that the risks of hospitalization were decreased by 22% under telemedicine intervention, compared to non-telemedical care (OR = 0.78, 95% CI 0.53-1.16, p-value 0.23), but without significant difference. The mean HbA1c in diabetes patients was significantly lower in the telemedicine group (mean difference -0.37, 95% CI -0.65 to -0.10, p-value <0.05). Telemedicine also significantly reduced the odds of hypoglycemia by 50% (OR 0.50, 95% CI 0.34 to 0.74, p-value < 0.05). Telemedicine reduced the number of mortalities compared to other care, but without significant difference. Conclusion: Telemedicine significantly reduced the mean HbA1c and the odds of hypoglycemia for diabetes patients, but its effect on reducing hospitalization and mortality for outpatients with chronic disease remained to be evaluated.