How safe and effective are paediatric virtual fracture clinics? A systematic review

Frontiers in Digital Health

Digital Health

Emma Waite¹  Zubair Ahmed² 

[1] College of Medical & Dental Sciences, University of Birmingham, Birmingham, United Kingdom;Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom;

关键词: paediatric;    child;    virtual fracture clinic;    telecommunication;    safety;    effectiveness;    cost reduction;    parent satisfaction;   

DOI  :  10.3389/fdgth.2023.1261035

 received in 2023-07-18, accepted in 2023-10-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionVirtual fracture clinics (VFC) involve a consultant-led multidisciplinary team meeting where cases are reviewed before a telephone consultation with the patient. VFCs have the advantages of reducing waiting times, outpatient appointments and time off school compared to face-to-face (F2F) fracture clinics. There has been a surge in VFC use since the COVID-19 pandemic but there are still concerns over safety in the paediatric population. Fractures make up a large burden of paediatric injuries, therefore research is required on the safety and efficacy of paediatric VFCs. This systematic review will look at the safety and effectiveness of paediatric VFCs, as well as determine the cost-effectiveness and parent preferences.MethodsAs per the PRISMA guidelines two independent reviewers searched the following databases: Medline, Embase and Web of Science. Studies were included if children under 18 years old presented to A&E with a suspected or confirmed simple un-displaced fracture and were referred to a VFC. The primary outcomes assessed were effectiveness and safety, with the secondary outcomes of cost-effectiveness and parent satisfaction.ResultsSix studies met the inclusion criteria for this systematic review. There was a high rate of direct discharge from the VFC leading to reduced outpatient appointments. All patients were seen within 72 h of presentation. There were limited incidences of missed fractures and the rates of re-presentation were similar to that of F2F orthopaedic clinics. There were significant cost savings for the hospitals and high parent satisfaction.DiscussionVFCs have shown to be safe and effective at managing most stable, low operative risk paediatric fractures. Safety must be ensured with a telephone helpline and an open return to fracture clinic policy. More research is needed into specific paediatric fracture types to be managed in the VFC.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier: CRD42023423795.

【 授权许可】

Unknown   
© 2023 Waite and Ahmed.