Article type
Year
Abstract
Background: since the first description of its utilisation published in 1879, telemedicine has been studied and used as a viable tool for improved treatment and therapeutic decision making in all health areas. It allows, with the use of often low-cost technologies, access to adequate health information for populations with difficult direct access, improving the quality of the treatments used.
Objectives: this study is a narrative review of Cochrane Systematic Reviews (CSR), developed with the aim of accessing the best evidence about the use of telemedicine instead of conventional treatment in varied health settings.
Methods: we performed a thorough search for all CSR that studied telemedicine as an intervention. In this narrative review, we did not study diagnostic telemedicine or studies with the use of automatic voice/text, or self-managed telemedicine. Three review authors checked all references independently. We discussed selected studies' eligibility criteria, results, main characteristics and certainty of evidence, and, if there was any disagreement, we consulted a fourth review author.
Results: we included 10 CSR, with a broad range of diseases and types of telemedicine. The evidence we found reported was of low quality to affirm that telemedicine could be effective in place of standard treatment. Only one review described a moderate quality of evidence, with the reduction of all-cause mortality risk in heart-failure patients and their hospitalisation.
Conclusions: further studies with more refined methods are desirable to ameliorate the certainty of the evidence of the benefits of telemedicine in all health fields.
Patient or healthcare consumer involvement: telemedicine can reduce costs and overcome land barriers, bringing the best evidence to faraway places and patients. This is already utilised in many countries but, in a continental one such Brazil, it is still in discussion, including in the legal field. With better evidence of its benefits, it could be more acceptable and legalised, making remote populations better able to be assisted by health teams, even if they are miles away. The dissemination of important clinical knowledge could also be improved by this approach, passing land barriers with just a click.
Objectives: this study is a narrative review of Cochrane Systematic Reviews (CSR), developed with the aim of accessing the best evidence about the use of telemedicine instead of conventional treatment in varied health settings.
Methods: we performed a thorough search for all CSR that studied telemedicine as an intervention. In this narrative review, we did not study diagnostic telemedicine or studies with the use of automatic voice/text, or self-managed telemedicine. Three review authors checked all references independently. We discussed selected studies' eligibility criteria, results, main characteristics and certainty of evidence, and, if there was any disagreement, we consulted a fourth review author.
Results: we included 10 CSR, with a broad range of diseases and types of telemedicine. The evidence we found reported was of low quality to affirm that telemedicine could be effective in place of standard treatment. Only one review described a moderate quality of evidence, with the reduction of all-cause mortality risk in heart-failure patients and their hospitalisation.
Conclusions: further studies with more refined methods are desirable to ameliorate the certainty of the evidence of the benefits of telemedicine in all health fields.
Patient or healthcare consumer involvement: telemedicine can reduce costs and overcome land barriers, bringing the best evidence to faraway places and patients. This is already utilised in many countries but, in a continental one such Brazil, it is still in discussion, including in the legal field. With better evidence of its benefits, it could be more acceptable and legalised, making remote populations better able to be assisted by health teams, even if they are miles away. The dissemination of important clinical knowledge could also be improved by this approach, passing land barriers with just a click.
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