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Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review
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8 2019
Source: J Am Geriatr Soc. 67(8):1737-1749 -
Alternative Title:J Am Geriatr Soc
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Personal Author:
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Description:Background:
Disparities in healthcare access and delivery caused by transportation and health workforce difficulties negatively impact individuals living in rural areas. These challenges are especially prominent in older adults.
Design:
We systematically evaluated the feasibility, acceptability and effectiveness in providing telemedicine searching the English-language literature for studies (January 2012 to July 2018) in the following databases: Medline (PubMed); Cochrane Library (Wiley); Web of Science; CINAHL; EMBASE (Ovid); and PsycINFO (EBSCO).
Participants:
Older adults (mean age ≥65 and none were less than 60 years)
Interventions:
Interventions consisted of live, synchronous, two-way video-conferencing communication in non-hospital settings. All medical interventions were included.
Measurements:
Quality assessment using the Cochrane Collaboration’s Risk of Bias Tool was applied on all included articles, including a qualitative summary of all articles.
Results:
Of 6,616 citations, we reviewed the full text of 1,173 articles, excluding 1,047 that did not meet criteria. Of the 17 randomized controlled trials, the United States was the country with the most trials (6 [35%]) with cohort sizes ranging from 3–844 (median 35) participants. Risk of bias among included studies varied from low to high. Our qualitative analysis suggests that telemedicine can improve health outcomes in older adults and that it could be used in this population.
Conclusions:
Telemedicine is feasible and acceptable in delivering care to older adults. Research should focus on well-designed randomized trials to overcome the high degree of bias observed in our synthesis. Clinicians should consider using telemedicine in routine practice to overcome barriers of distance and access to care.
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Pubmed ID:31066916
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Pubmed Central ID:PMC6684409
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