Archive \ Volume.15 2024 Issue 2

Impact of Telemedicine on the Clinical Outcomes among Elderly Patients: A Systematic Review

Mohammad Akbar Hossain*✉
  1. Department of Pharmacology and Toxicology, Faculty of Medicine in Al-Qunfudah, Umm Al-Qura University, Makkah, KSA.

Abstract

Telemedicine has been increasingly used in the provision of health care services to older adults. The objective of this study was to investigate the impact of telemedicine use on clinical and self-reported outcomes of older patients through systematic review and meta-analysis. Online search was made from PubMed, psycINFO, Scopus, Ovid (Embase, Emcare), and EBSCOhost for randomized controlled trials and quasi-experimental studies evaluating the effect of telemedicine on clinical and self-reported outcomes of older patients (age>60 years). A total of seven studies were included in this review. Among the clinical outcomes, telemedicine had a statistically significant effect on systolic blood pressure (-3.83; 95% CI [-6.04, -1.61]; I2=77%;p=0.001) and glycosylated hemoglobin (-0.20; 95% CI [-0.35, -0.04]; I2=0; p=0.01). Whereas, no significant effect was observed for diastolic blood pressure (-0.92;95%CI [-2.14,0.30]; I2 0%; p=0.44), low-density lipoprotein (-0.01; 95%CI [-0.09,0.07]; I2=0%;p=0.930), and body weight (0.15;95%CI [-0.74,1.05]; I2 =0%;p=0.420. Depressive symptoms rating was assessed using two different measurement tools, Geriatric Depression Scale (GDS) and Patient Health Questionnaire 9 (PHQ-9). Significant effect was reported with PHQ-9 (-3.11;95%CI [-4.68,-1.55];I2=93%;p=0.0002). Results from this systematic review suggest that key clinical outcomes and health behavior of older patients can be improved using telemedicine.


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Vancouver
Hossain MA. Impact of Telemedicine on the Clinical Outcomes among Elderly Patients: A Systematic Review. Arch Pharm Pract. 2024;15(2):82-92. https://doi.org/10.51847/2tavelw0xJ
APA
Hossain, M. A. (2024). Impact of Telemedicine on the Clinical Outcomes among Elderly Patients: A Systematic Review. Archives of Pharmacy Practice, 15(2), 82-92. https://doi.org/10.51847/2tavelw0xJ

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References
  1. Cannon NJ, Jurski K, Ulferts GW. Telemedicine. Am J Health Sci. 2014;5(2):95-102.
  2. Edwards JP. Dictionary of Nursing 6th Ed. Refer. 2014;30(1):22. Available from: http://www.oxfordreference.com.ezproxy.lib.monash.edu.au/view/10.1093/acref/9780199666379.001.0001/acref-9780199666379-e-8865
  3. Telemedicine WH. Opportunities and developments in member states. Geneva, Switzerland. 2010. Available from: http://apps.who.int/iris/bitstream/handle/10665/44497/9789241564144_eng.pdf;jsessionid=0E1E569EE94289E95B4A7530282FA369?sequence=1
  4. Hermans H, Evenhuis HM. Multimorbidity in older adults with intellectual disabilities. Res Dev Disabil. 2014;35(4):776-83. 
  5. Ellison D, White D, Farrar FC. Aging population. Nurs Clin North Am. 2015;50(1):185-213.
  6. Au DH, Macaulay DS, Jarvis JL, Desai US, Birnbaum HG. Impact of a telehealth and care management program for patients with chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2015;12(3):323-31.
  7. Bashshur RL, Shannon GW, Smith BR, Alverson DC, Antoniotti N, Barsan WG, et al. The empirical foundations of telemedicine interventions for chronic disease management. Telemed J E Health. 2014;20(9):769-800. 
  8. Chaudhry SI, Phillips CO, Stewart SS, Riegel B, Mattera JA, Jerant AF, et al. Telemonitoring for patients with chronic heart failure: A systematic review. J Card Fail. 2007;13(1):56-62.
  9. Clark RA, Inglis SC, McAlister FA, Cleland JG, Stewart S. Telemonitoring or structured telephone support programmes for patients with chronic heart failure: Systematic review and meta-analysis. BMJ. 2007;334(7600):942. 
  10. Inglis SC, Clark RA, Dierckx R, Prieto-Merino D, Cleland JG. Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Database Syst Rev. 2015;2015(10):CD007228. 
  11. Kitsiou S, Paré G, Jaana M. Effects of home telemonitoring interventions on patients with chronic heart failure: An overview of systematic reviews. J Med Internet Res. 2015;17(3):e63. 
  12. Dang S, Dimmick S, Kelkar G. Evaluating the evidence base for the use of home telehealth remote monitoring in elderly with heart failure. Telemed J E Health. 2009;15(8):783-96. 
  13. Paré G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: The evidence base. J Am Med Inform Assoc. 2007;14(3):269-77. doi:10.1197/jamia.M2270
  14. Chen K, Chan AH. Predictors of gerontechnology acceptance by older Hong Kong Chinese. Technovation. 2014;34(2):126-35.
  15. Kohlbacher F, Herstatt C, Levsen N. Golden opportunities for silver innovation: How demographic changes give rise to entrepreneurial opportunities to meet the needs of older people. Technovation. 2015;39:73-82.
  16. Yang HL, Hsiao SL. Mechanisms of developing innovative IT-enabled services: A case study of Taiwanese healthcare service. Technovation. 2009;29(5):327-37.
  17. Finkelstein SM, Speedie SM, Potthoff S. Home telehealth improves clinical outcomes at lower cost for home healthcare. Telemed J E Health. 2006;12(2):128-36. 
  18. Minetaki K, Akematsu Y, Tsuji M. Effect of e-health on medical expenditures of outpatients with lifestyle-related diseases. Telemed J E Health. 2011;17(8):591-5.
  19. Noel HC, Vogel DC, Erdos JJ, Cornwall D, Levin F. Home telehealth reduces healthcare costs. Telemed J E Health. 2004;10(2):170-83. 
  20. Lee SWH, Chan CKY, Chua SS, Chaiyakunapruk N. Comparative effectiveness of telemedicine strategies on type 2 diabetes management: A systematic review and network meta-analysis. Sci Rep. 2017;7(1):12680. 
  21. Higgins JP. Cochrane handbook for systematic reviews of interventions. Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration. www.cochrane-handbook.org. 2011.
  22. Choi H, Kim J. Effectiveness of telemedicine: Videoconferencing for low-income elderly with hypertension. Telemed J E Health. 2014;20(12):1156-64. doi:10.1089/tmj.2014.0031
  23. De Luca R, Bramanti A, De Cola MC, Trifiletti A, Tomasello P, Torrisi M, et al. Tele-health-care in the elderly living in nursing home: The first Sicilian multimodal approach. Aging Clin Exp Res. 2016;28(4):753-9.
  24. Gellis ZD, Kenaley B, McGinty J, Bardelli E, Davitt J, Ten Have T. Outcomes of a telehealth intervention for homebound older adults with heart or chronic respiratory failure: A randomized controlled trial. Gerontologist. 2012;52(4):541-52.
  25. Gellis ZD, Kenaley BL, Ten Have T. Integrated telehealth care for chronic illness and depression in geriatric home care patients: The integrated telehealth education and activation of mood (I-TEAM) study. J Am Geriatr Soc. 2014;62(5):889-95.
  26. Karhula T, Vuorinen AL, Rääpysjärvi K, Pakanen M, Itkonen P, Tepponen M, et al. Telemonitoring and mobile phone-based health coaching among finnish diabetic and heart disease patients: Randomized controlled trial. J Med Internet Res. 2015;17(6):e153. 
  27. Lyons EJ, Swartz MC, Lewis ZH, Martinez E, Jennings K. Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: A randomized controlled pilot trial. JMIR Mhealth Uhealth. 2017;5(3):e28.
  28. Shea S, Weinstock RS, Teresi JA, Palmas W, Starren J, Cimino JJ, et al. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. J Am Med Inform Assoc. 2009;16(4):446-56. 
  29. Basile JN. Systolic blood pressure. BMJ. 2002;325(7370):917-8. doi:10.1136/bmj.325.7370.917
  30. Bundy JD, Li C, Stuchlik P, Bu X, Kelly TN, Mills KT, et al. Systolic blood pressure reduction and risk of cardiovascular disease and mortality: A systematic review and network meta-analysis. JAMA Cardiol. 2017;2(7):775-81.
  31. Grossman E. Blood pressure: The lower, the better: The con side. Diabetes Care. 2011;34 Suppl 2(Suppl 2):S308-12.
  32. Clark NG, Pawlson G. Change in HbA1c as a measure of quality of diabetes care: Response to spitz. Diabetes care. 2006;29(5):1184-5.
  33. Karyekar CS, Frederich R, Ravichandran S. Clinically relevant reductions in HbA1c without hypoglycaemia: results across four studies of saxagliptin. Int J Clin Pract. 2013;67(8):759-67.
  34. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights. 2016;11:95-104. 
  35. Franco MR, Pereira LS, Ferreira PH. Exercise interventions for preventing falls in older people living in the community. Br J Sports Med. 2014;48(10):867-8. 
  36. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;2012(9):CD007146. 
  37. Rubenstein LZ, Josephson KR, Trueblood PR, Loy S, Harker JO, Pietruszka FM, et al. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. J Gerontol A Biol Sci Med Sci. 2000;55(6):M317-21. 
  38. Feldman DI, Al-Mallah MH, Keteyian SJ, Brawner CA, Feldman T, Blumenthal RS, et al. No evidence of an upper threshold for mortality benefit at high levels of cardiorespiratory fitness. J Am Coll Cardiol. 2015;65(6):629-30.

 

 

 


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