Patient satisfaction with e-oral health care in rural and remote settings: a systematic review

Abstract

Background During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities. Methods The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies. Results Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients. Conclusion Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings. Systematic review registration The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.

A Systematic Umbrella Review of the Effects of Teledentistry on Costs and Oral-Health Outcomes

“…One review's conclusion about the costs was in contrast with the conclusion stated in the original article and was therefore excluded during the data-selection process [30]. In total, 10 reviews were included in this umbrella review [31][32][33][34][35][36][37][38][39][40].…”

“…and was therefore excluded during the data-selection process [30]. In total, 10 reviews were included in this umbrella review [31][32][33][34][35][36][37][38][39][40]. Table 1 presents an overall description of the included reviews characteristics and findings.…”

“…Ten reviews focused on outcomes with regard to costs and economic evaluations; of these, only five [31,32,[35][36][37] provide reports on costs as outcomes of interest in their reviews and included a review of studies of true economic evaluation as defined by Drummond and collaborators (2005) [18]. The review conducted by Aquilanti and collaborators [31] included three studies reporting economic evaluations.…”

“…A more recent review by Emami and collaborators [36] identified seven studies which include some elements of economic evaluation and used the level of evidence according to the Oxford Centre for Evidence-Based Medicine [41]. On the other hand, Daniel and collaborators [35] and Ben-Omran and collaborators [32] included two studies each that were found to be economic evaluations, but no evaluation tool was mentioned to facilitate the quality-evaluation task.…”

Oral health in emerging countries and suggestions for adjusted care strategies

“…The method was seen as so reliable and effective for patients in these areas that the authors recommend encouraging TD in similar parts of the country. 100 The same is true for dental therapists, who get a two to three year academic education in dental hygiene and dental therapy, and deliver quality care comparable to dentists. [101][102][103][104] Patient acceptance and satisfaction is evidenced in countries like New Zealand, Australia, the Netherlands, Malaysia, Thailand and Vietnam.…”