Saturday, July 13, 2024

Effectiveness of Telehealth Versus In-Person Care During the Pandemic: A Systematic Review

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As the COVID-19 pandemic reshaped healthcare delivery worldwide, telehealth emerged as a pivotal alternative to in-person consultations. This transition prompted a comprehensive analysis of telehealth’s efficacy compared to traditional care methods. Utilizing databases such as PubMed, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials, researchers conducted a systematic review encompassing studies from March 2020 to April 2023. The review aimed to evaluate the differential impacts of telehealth and in-person care on various healthcare outcomes in a U.S. context.

Methodology and Study Selection

The review incorporated English-language studies pertinent to U.S. healthcare that compared telehealth with in-person care post-pandemic onset. Two independent reviewers meticulously screened the search results, extracted relevant data, and assessed each study’s bias risk and evidence strength. Out of 77 identified studies, 61% were found to have a serious or high risk of bias, indicating potential limitations in the study designs.

Despite the high bias risk, the findings revealed minimal and not clinically significant differences in healthcare utilization and clinical outcomes between the two care modalities. The effectiveness varied depending on the specific outcome and clinical area under consideration.

Key Findings and Implications

For process-related outcomes, telehealth demonstrated a lower rate of missed visits and therapy/medication changes, alongside higher adherence rates compared to in-person care. However, telehealth patients had lower rates of up-to-date laboratory and paraclinical assessments. The lack of standardized outcome assessment methods across most studies was a notable limitation, complicating definitive conclusions about telehealth’s performance relative to traditional care.

The review underscores the need for developing integrated care models that combine telehealth and in-person visits as we navigate the ongoing pandemic and its aftermath. Continuous evaluation of telehealth’s effectiveness will be crucial in optimizing healthcare delivery.

User-Usable Inferences

  • Telehealth can reduce the rate of missed medical appointments.
  • Patients tend to adhere better to their prescribed therapies and medications with telehealth care.
  • Telehealth may result in fewer up-to-date laboratory assessments, necessitating supplemental in-person visits.
  • Standardizing outcome assessment methods in telehealth research is essential for reliable comparisons.

In conclusion, the systematic review indicates that while there are various nuances in outcomes, telehealth presents a viable alternative to in-person care in many clinical scenarios. The integration of telehealth within traditional healthcare frameworks is vital for future advancements and patient care optimization.

Original Article: NPJ Digit Med. 2024 Jun 15;7(1):157. doi: 10.1038/s41746-024-01152-2.

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