Remote versus face-to-face check-ups for asthma

Kew, Kayleigh M; Cates, Christopher J

doi:10.1002/14651858.cd011715.pub2

Cited by 43 publications

(45 citation statements)

References 93 publications

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“…27 Furthermore, two recent meta-analyses have demonstrated no differences in asthma outcomes between telemedicine and face-to-face visits for asthma in children and adults. 28,29 The meta-analyses included very few studies that utilized the integrated approach demonstrated in this study with VBT medical and self-management visits and electronic inhaler monitoring in adolescents living in economically disadvantaged neighborhoods and the majority of studies were conducted in rural or remote settings or enrolled young children. [30][31][32][33][34]…”

Section: Discussionmentioning

confidence: 99%

Telehealth delivery of adherence and medication management system improves outcomes in inner‐city children with asthma

Lin

Ramsey

Miller

et al. 2020

Pediatric Pulmonology

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Healthcare disparities exist in pediatric asthma in the United States. Children from minority, low‐income families in inner‐city areas encounter barriers to healthcare, leading to greater rates of poorly controlled asthma and healthcare utilization. Finding an effective way to deliver high‐quality healthcare to this underserved population to improve outcomes, reduce morbidity and mortality, and reduce healthcare utilization is of the utmost importance. The purpose of this study was to assess the feasibility and efficacy of a novel school‐based care delivery model that incorporates video‐based telehealth (VBT) medical and self‐management visits with electronic inhaler monitoring to improve asthma outcomes. Over a 6‐month period, children from inner‐city, low‐income schools with uncontrolled asthma completed seven scheduled medical visits with an asthma specialist and five self‐management visits with an adherence psychologist at school using VBT. Composite Asthma Severity Index (CASI) scores and electronic inhaler monitor data were recorded and analyzed. A total of 21 patients were enrolled in the study. Study subjects with higher baseline severity (CASI ≥ 4 at visit 1) demonstrated a greater reduction in their score than those with lower baseline severity (CASI < 4 at visit 1). The CASI domains showed improvement in daytime symptoms, nighttime symptoms, and exacerbations. Adherence results demonstrated a significant improvement in adherence from baseline to postintervention. Study retention was 100%. This study demonstrates that a multicomponent medical and behavioral interventional program delivered by VBT to a school‐based setting is feasible and can significantly improve asthma outcomes and care in a challenging population.

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Section: Discussionmentioning

confidence: 99%

Telehealth delivery of adherence and medication management system improves outcomes in inner‐city children with asthma

Lin

Ramsey

Miller

et al. 2020

Pediatric Pulmonology

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“…Lung function assessed by means of forced expiratory volume in the first second (FEV1) was only reported in one study. The authors of this review 10 Total number of exacerbations was only analyzed in one RCT, with borderline statistical significance (P = 0.06). In another trial, it was reported that the mean number of exacerbations per month was significantly higher among the controls than in the telehealthcare group (0.78 ± 0.77 and 0.23 ± 0.38, respectively; P < 0.0001).…”

Section: Remote Check-ups For Asthmamentioning

confidence: 94%

What do Cochrane systematic reviews say about telemedicine for healthcare?

et al. 2019

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BACKGROUND: Telemedicine has emerged as a tool for overcoming the challenges of healthcare systems and is likely to become increasingly viable, since information and communication technologies have become more sophisticated and user-friendly. OBJECTIVE: We aimed to identify all Cochrane systematic reviews (CSRs) on telemedicine within healthcare and to summarize the current evidence regarding its use. DESIGN AND SETTING: Review of CSRs, developed at the Discipline of Emergency and Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS:We searched for studies that compared use of telemedicine with conventional treatment or management of diseases within healthcare. Diagnostic telemedicine studies or studies using automatic text, voice-text or even self-managed care were excluded. The main characteristics and the certainty of evidence were synthetized and critically discussed by all authors. RESULTS: We included 10 CSRs that investigated a broad range of diseases. There is still insufficient evidence to determine what types of telemedicine interventions are effective, for which patients and in which settings, and whether such interventions can be used as a replacement for the standard treatment. Harm relating to telemedicine technologies needs to be better investigated and addressed. CONCLUSION: Telemedicine might be an excellent way to facilitate access to treatment, monitoring and dissemination of important clinical knowledge. However, given the recognition of systematic reviews as the best evidence resource available for decision-making, further randomized controlled trials with stricter methods are necessary to reduce the uncertainties in evidence-based use of telemedicine.

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“…As for the situations in which medical teleconsultation can be indicated, this review identified 11 studies that addressed specific conditions, 7 of which used video teleconsultation and the other three used the electronic consultation system or a combination of video and telephone or even video, phone and email. Studies that compared medical teleconsultation by video with faceto-face consultations identified equivalent results regarding glycemic control of individuals with diabetes 39 , as well as in exacerbations, disease control and quality of life of patients with asthma 34 and in the treatment of childhood obesity 37 . High rates of satisfaction were also identified among patients treated for rheumatological diseases 47 and better experience of care and health outcomes in nephrology care 35 .…”

Section: Teleconsultation Indicationsmentioning

confidence: 99%

“…However, in the latter case, the authors warned about being careful in generalizing the results 23 . Other studies also indicate the need for future studies 30,34,47 , with a promising potential 37 .…”

Section: Teleconsultation Indicationsmentioning

confidence: 99%

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Catapan

Calvo

2020

Rev. bras. educ. med.

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Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.

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Remote versus face-to-face check-ups for asthma

Cited by 43 publications

References 93 publications

Telehealth delivery of adherence and medication management system improves outcomes in inner‐city children with asthma

Telehealth delivery of adherence and medication management system improves outcomes in inner‐city children with asthma

What do Cochrane systematic reviews say about telemedicine for healthcare?

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

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