Assessment of Research Quality of Telehealth Trials in Pain Management: A Meta‐Analysis

Abstract

Although telehealth-based pain management research has grown over the last decade, it is difficult to determine the state of the research because of methodological differences and variability in quality among existing studies. In a previous systematic review, we outlined these differences and preliminarily explored the promise of telehealth for pain intervention. We completed a PRISMA compliant meta-analysis of telehealth pain management research to more precisely describe the state of the research and to uncover gaps in the existing literature that highlight directions for future research. We identified 10 relevant studies completed between 2000 and 2011 including 3 noninferiority and 7 superiority studies. Meta-analysis revealed an overall benefit of telehealth interventions over control conditions and equivalence with in-person intervention. However, some of the reviewed studies found no benefit for telehealth over control conditions. Some methodological concerns among the examined research included poor research quality, small sample sizes, and the examination of telehealth pain interventions without proven efficacy for in-person treatment. Recommendations for future studies are reviewed.

Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

“…Pooled analyses were performed in 4 reviews and presented subsequently [22-24,27]. One review on chronic obstructive pulmonary disease (COPD) demonstrated the capacity of eHealth interventions to significantly reduce the number of patients with 1 or more emergency department visits or hospital admissions-due to exacerbation of pulmonary symptoms-over a 12-month period [23].…”

“…Because the interventions were often part of complex interventions, the authors concluded that further investigation is required to determine the precise role of eHealth. Promising effects were also identified for Internet-based peer and clinical visit support programs—among several other eHealth interventions—in acute and chronic pain management [18,22]. Although the Internet was supportive in the treatment of pain, it remained unclear what benefits could be gained and which patients would profit most.…”

Design of telehealth trials – Introducing adaptive approaches

“…Non-compliance may arise if the telehealth programme is too demanding or timeconsuming [28]. It may also arise because of poor usability.…”

The role of digital communication in patient–clinician communication for NHS providers of specialist clinical services for young people [the Long-term conditions Young people Networked Communication (LYNC) study]: a mixed-methods study

“…This is significant as the authors note that unpublished material could have provided additional insights. 352 Although Peeters et al 354 supply funding details, they do not specifically report any conflict of interest. For Conway et al's 342 subanalysis, full search terms, the inclusion of unpublished literature and list of excluded studies, and in-depth risk and publication assessments were appraised in the original systematic review and meta-analysis publication.…”

“…Although McGeary et al 352 searched for grey literature, they excluded it later without giving any reasons. This is significant as the authors note that unpublished material could have provided additional insights.…”