R for HTA 2022 Workshop - Adrija Roy
Channel: R-HTA consortium
Date: 2022-06-01

Title:
Telemedicine in secondary healthcare: A multidimensional systematic review

Abstract:

Introduction:The use of telemedicine has been common in recent times for providing primary healthcare in areas where healthcare facilities are not adequate. But, its use in secondary care or specialist care, though not as common, has many potentials to bridge the equity gaps.Objectives:To examine the existing literature on the health benefits, non-health benefits and, patient satisfaction for those seeking specialist care through telemedicine compared to the routine care pathway.

Methodology:A protocol was registered with PROSPEROa prospective register of systematic reviews and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A naÃ¯ve search using PubMed/MEDLINE, Cochrane, Web of Science, and Google Scholar was conducted using appropriate keywords and MeSH terms, with search strings tailored to the objectives. The search strategy was based on the use of boolean operators keeping in mind the PICO format, with MeSH and general keywords identified within each PICO component separated by â€œORâ€ and connected with each other using â€œANDâ€ operators. Following an initial search, R package litsearchr was used to identify missed terms further, if any. All the articles obtained were independently assessed by two investigators for suitability through title and abstract review. 

Results: A total of 3431 titles/abstracts were identified after the initial naÃ¯ve search. After abstract screening, a total of 241 articles were chosen for additional full paper skimmed reading, finally a total of 19 RCTs were included in the review. The majority of the articles explored the benefits of telemedicine in secondary care through economic analyses or disease outcomes but only a few studies explored the use of telemedicine for secondary care in LMICs, and the majority were from HICs.

Conclusions:There is substantial evidence showing the effectiveness of specialist or secondary care through telemedicine services, and therefore, this potential could be explored to bridge the healthcare equity gaps further.