Telemedicine in the primary care of older adults: a systematic mixed studies review

BMC Primary Care

Research

Isabelle Vedel¹  Marwa Ilali¹  Vladimir Khanassov²  Mélanie Le Berre³ 

[1] Department of Family Medicine, McGill University, 5858 Côte-Des-Neiges Road, 3Rd Floor, H3S 1Z1, Montreal, Québec, Canada;Department of Family Medicine, McGill University, 5858 Côte-Des-Neiges Road, 3Rd Floor, H3S 1Z1, Montreal, Québec, Canada;Goldman Herzl Family Practice Centre, Jewish General Hospital, Montreal, Canada;Department of Family Medicine, McGill University, 5858 Côte-Des-Neiges Road, 3Rd Floor, H3S 1Z1, Montreal, Québec, Canada;School of Rehabilitation Science, Université de Montréal, Montreal, Canada;Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada;

关键词: Telemedicine;    Family Practice;    Primary Care;    Aged;    Systematic Review;    Mixed Methods;   

DOI  :  10.1186/s12875-023-02085-7

 received in 2022-08-19, accepted in 2023-06-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFamily physicians had to deliver care remotely during the COVID-19 pandemic. Their efforts highlighted the importance of developing a primary care telemedicine (TM) model. TM has the potential to provide a high-quality option for primary care delivery. However, it poses unique challenges for older adults. Our aim was therefore to explore the effects of TM and the determinants of its use in primary care for older adults.MethodsIn this systematic mixed studies review, MEDLINE, PsycINFO, EMBASE, CINHAL, AgeLine, DARE, Cochrane Library, and clinical trials research registers were searched for articles in English, French or Russian. Two reviewers performed study selection, data extraction and assessment of study quality. TM’s effects were reported through the tabulation of key variables. TM use determinants were interpreted using thematic analysis based on Chang’s framework. All data were integrated using a joint display matrix.ResultsFrom 3,328 references identified, 20 studies were included. They used either phone (n = 8), videoconference (n = 9) or both (n = 3). Among studies reporting positive outcomes in TM experience, ‘user habit or preferences’ was the most cited barrier and ‘location and travel time’ was the most cited facilitator. Only one study reported negative outcomes in TM experience and reported ‘comfort with patient communication’ and ‘user interface, intended use or usability’ as barriers, and ‘technology skills and knowledge’ and ‘location and travel time’ as facilitators.Among studies reporting positive outcomes in service use and usability, no barrier or facilitator was cited more than once. Only one study reported a positive outcome in health-related and behavioural outcomes.ConclusionsTM in older adults’ primary care generally led to positive experiences, high satisfaction and generated an interest towards alternative healthcare delivery model. Future research should explore its efficacy on clinical, health-related and healthcare services use.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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