Domains, Feasibility, Effectiveness, Cost, and Acceptability of Telehealth in Aging Care: Scoping Review of Systematic Reviews (Preprint)

Abstract

BACKGROUND Global ageing is becoming a major global challenge. Older adults often have greater health needs compared to the younger generation but are facing inadequate access to appropriate, affordable, and high-quality health care. Telehealth can remove the geographic and time boundaries, as well as enabling the socially isolated and physically homebound people to access a wider range of care options. A variety of telehealth interventions have been designed and applied in different settings to older people with different health conditions, but the results regarding their feasibility, effectiveness, cost, and acceptability were not consistent. OBJECTIVE This review aims to consolidate the evidence of telehealth's feasibility, effectiveness, cost-effectiveness, and acceptability in the context of ageing care, identify gaps in the literature, and determine the priorities for future research. METHODS Guided by the methodological framework of the Joanna Briggs Institute (JBI), we reviewed systematic reviews concerning all types of telehealth interventions involving direct communication between older users and healthcare providers. Five major electronic databases, PubMed, Embase (Ovid), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO (EBSCO) were searched on 16th September 2021, and an updated search was performed on 28th April 2022 across the same databases as well as the first ten pages of the Google search. RESULTS 29 systematic reviews including one post-hoc sub-analysis of a previously published large Cochrane systematic review with meta-analysis were included. We summarized the domains, as well as evidence of the feasibility, effectiveness, cost, and acceptability of telehealth. Having better-designed telehealth interventions, improved telehealth policies and regulations, as well as more high-quality and rigorous future research is crucial to strengthening the research evidence and addressing the increasingly multi-faceted health needs of older adults. CONCLUSIONS Though telehealth remains in its infancy and there is a lack of high-quality studies to rigorously prove the feasibility, effectiveness, cost-effectiveness, and acceptability of telehealth, mounting evidence has indicated that it is playing an important complementary role in the care of the ageing population.