Study protocol randomised controlled trial comparison of cost–utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain

Castro-Sánchez, Adelaida M.; Matarán-Peñarrocha, Guillermo A.; Gómez-García, Silvia; García‐López, Héctor; Andronis, Lazaro; Casaña, José; Lara‐Palomo, Inmaculada Carmen

doi:10.1136/bmjopen-2020-040633

Cited by 6 publications

(5 citation statements)

References 55 publications

(50 reference statements)

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“…Telehealth increases the convenience and accessibility of health care services for patients when access to in‐person services is limited or unnecessary and extends the geographic reach of health care facilities and specialized disciplines 4,5 . Telehealth can reduce health care‐related costs associated with patients' lost wages, lost productivity, and travel time 6 . Telehealth facilitates more engaging and efficient management of chronic conditions and allows members of the patient care team, such as pharmacists to connect with patients and thereby improve patient outcomes 5,7‐9 .…”

Section: Introductionmentioning

confidence: 99%

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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IntroductionTelehealth offers a promising opportunity for the delivery of clinical pharmacy services by increasing the accessibility of health care, extending the reach of clinical services, and allowing pharmacists to engage with patients who might otherwise be overlooked. The objectives of the project were to discover effective strategies for the delivery of clinical pharmacy services via telehealth and to identify core components of comprehensive medication management (CMM) that are deliverable via telehealth.MethodsA systematic literature review was performed by searching four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], PubMed, Scopus, and Web of Science) for relevant citations using keywords and subject headings relating to telemedicine, clinical pharmacy services, and health conditions. Studies were eligible for inclusion in the review if the interventions they describe involved telehealth technologies and pharmacist care. Blind screening of abstracts and full‐text review was completed by six researchers divided into teams of two. Any discrepancies were resolved by the corresponding author.ResultsFifty‐nine studies met the inclusion criteria, most (n = 53) of which were conducted in the U.S. Five studies (8.5%) reported pharmacist training as an implementation strategy. The telehealth technologies most regularly utilized were telephone‐based interventions (n = 45), videoconferences (n = 13), and web‐based (n = 4) interventions, with five studies using a combination of technologies. Most studies focused on hypertension (n = 22), diabetes (n = 20), or lipid‐related (n = 14) disease state management. Eighteen studies qualified as CMM (n = 18), with most involving all five essential CMM functions.ConclusionThis systematic review study highlights opportunities for pharmacists to deliver clinical pharmacy services using telehealth. The majority of clinical pharmacy services described in the accessed literature was provided via telephone and focused on targeted monitoring of disease states. While studies reporting the use of CMM interventions were limited, there is an opportunity to increase the application of CMM principles as healthcare systems transition to providing more telehealth services.

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Section: Introductionmentioning

confidence: 99%

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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“…Future health economic studies of telehealth for physiatry and rehabilitation services will be needed. One such randomized clinical trial comparing cost-utility and cost-effectiveness of in-person and telemedicine treatment for chronic low back pain is underway ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Patient experiences receiving rehabilitation care via telehealth: Identifying opportunities for remote care

Goldman

Merkitch²,

Brewington³

et al. 2023

Front. Rehabil. Sci.

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Use of telehealth has grown substantially in recent times due to the COVID-19 pandemic. Remote care services may greatly benefit patients with disabilities; chronic conditions; and neurological, musculoskeletal, and pain disorders, thereby allowing continuity of rehabilitation care, reducing barriers such as transportation, and minimizing COVID-19 exposure. In March 2020, our rehabilitation hospital, Shirley Ryan AbilityLab, launched a HIPAA-compliant telemedicine program for outpatient and day rehabilitation clinics and telerehabilitation therapy programs. The objective of this study was to examine patients' experiences and satisfaction with telemedicine in the rehabilitation physician practice, including novel virtual multidisciplinary evaluations. The present study examines survey data collected from 157 patients receiving telemedicine services at Shirley Ryan AbilityLab from December 2020–August 2021. Respondents were 61.8% female, predominantly White (82.2%) with ages ranging across the lifespan (69.4% over age 50 years). Diagnostic categories of the respondents included: musculoskeletal conditions 28%, chronic pain 22.3%, localized pain 10.2%, neurological conditions 26.8%, and Parkinson's and movement disorders 12.7%. Survey responses indicate that the telemedicine experiences were positive and well received. The majority of participants found these services easy to use, effective, and safe, and were overall satisfied with the attention and care they received from the providers—even for those who had not previously used telehealth. Respondents identified a variety of benefits, including alleviating financial and travel-related burdens. There were no significant differences in telehealth experiences or satisfaction across the different clinical diagnostic groups. Respondents viewed the integrated physician and rehabilitation therapist telehealth multidisciplinary model favorably, citing positive feedback regarding receiving multiple perspectives and recommendations, feeling like an integrated member of their healthcare team, and having a comprehensive, holistic team approach along with effective communication. These findings support that telemedicine can provide an effective care model in physiatry (physical medicine and rehabilitation) clinics, across different neurological, musculoskeletal, and pain conditions and in multidisciplinary team care settings. The insights provided by the present study expand our understanding of patient experiences with remote care frameworks for rehabilitation care, while controlling for institutional variation, and ultimately will help provide guidance regarding longer term integration of telemedicine in physiatry and multidisciplinary care models.

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“…Las medidas de control de acceso a los centros sanitarios, dando preferencia a la telemedicina frente a las consultas presenciales y los recursos de prevención de contagio, motivaron que el control de PA bajase al 9,3 % en la farmacia comunitaria y al 4,2 % en el CS, lo que repercute en el seguimiento de estos pacientes. Beckam et al (18) establece que el uso de la telemedicina durante el confinamiento reduce un 50 % las probabilidades de tener registros de PA y un estudio de Castro AM (19) señala que la interrupción en los cuidados puede tener consecuencias que deben ser valoradas cuanto antes para revertir la situación a antes del confinamiento. Además, hay que tener en cuenta que del 56,74 % que usó telemedicina solo estuvo satisfecho el 35,81 %, por lo que las dificultades en el acceso a la atención médica, bien por la falta de presencialidad, bien por la falta de disponibilidad consecuencia de la situación sanitaria, también pueden repercutir en el control de PA.…”

Section: Discussionunclassified

Cambios producidos en el paciente con hipertensión durante el confinamiento que podrían modificar su riesgo cardiovascular

Álvarez¹,

Villasuso²,

Más³

et al. 2022

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Introducción: la pandemia SARS-CoV-2 ha provocado importantes cambios en el sistema sanitario y como consecuencia retrasos en el control de las patologías crónicas. Además, el confinamiento impuso una serie de restricciones que modificaron las condiciones habituales, por lo que resulta de interés conocer su influencia en el paciente con hipertensión.Objetivos: determinar los cambios en los hábitos de estilos de vida saludables durante el confinamiento, en hipertensos tratados y que pudieran agravar su riesgo cardiovascular (RCV).Métodos: estudio observacional, transversal y descriptivo realizado del 10 de junio al 10 de julio de 2020 en farmacias comunitarias españolas. Los pacientes cumplimentaron un cuestionario sobre el conocimiento de su enfermedad y factores que pudieron afectarse durante el confinamiento.Resultados: participaron 215 pacientes. Un 84,7 % afirmó conocer su enfermedad, el 56,7 % conocía sus valores de presión arterial (PA). Un 9,6 % no se la controlaba antes, pasando al 46,3 % durante el confinamiento. La mayoría mantuvo sus hábitos de estilo de vida saludables, excepto en el ejercicio donde disminuyó un 68,4 %. El 34,9 % refiere haber sufrido ansiedad; 27 % tiene miedo de acudir a enfermería, 27,9 % al médico y 10,2 % a la farmacia. El 56,7 % usó telemedicina.Conclusiones: dentro de los hábitos saludables el confinamiento no ha modificado sustancialmente los hábitos alimenticios, pero ha supuesto una importante disminución del ejercicio físico y aumento de peso en la mitad de los pacientes, que, junto con la disminución en el control de los valores y seguimiento, repercute negativamente en el control de la PA y el RCV.

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Study protocol randomised controlled trial comparison of cost–utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain

Cited by 6 publications

References 55 publications

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Patient experiences receiving rehabilitation care via telehealth: Identifying opportunities for remote care

Cambios producidos en el paciente con hipertensión durante el confinamiento que podrían modificar su riesgo cardiovascular

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