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Meta-Analysis
. 2022 Apr 19;22(1):105.
doi: 10.1186/s12911-022-01845-2.

Telemedicine application in patients with chronic disease: a systematic review and meta-analysis

Yue Ma #  1 , Chongbo Zhao #  2 , Yan Zhao  1 , Jiahong Lu  2 , Hong Jiang  1 , Yanpei Cao  3 , Yafang Xu  4   5
Affiliations
Meta-Analysis

Telemedicine application in patients with chronic disease: a systematic review and meta-analysis

Yue Ma et al. BMC Med Inform Decis Mak. .

Abstract

Background: Telemedicine has been widely used for long-term care and self-management in patients with chronic disease, but there is no consensus regarding the effect of telemedicine on chronic disease management. The aim of this study is to review and analyse the effect of telemedicine on the management of chronic diseases such as hypertension, diabetes, and rheumatoid arthritis using a systematic review and meta-analysis.

Methods: We performed a comprehensive literature search of the Web of Science, PubMed, MEDLINE, EMBASE, CNKI (Chinese database), VIP (Chinese database), WanFang (Chinese database), and SinoMed (Chinese database) databases from their inception until December 31, 2021. The retrieved literature was screened and assessed independently by two authors. We used the risk-of-bias assessment tool recommended by the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2 for assessing literature quality and Revman 5.3 software to conduct the meta-analysis.

Results: Fifteen articles were included in this study. The results of the systematic review indicated that telemedicine consultation and telemonitoring are the most commonly used intervention methods. Telemedicine is helpful for improving self-management in patients with rheumatoid arthritis. The results of the meta-analysis showed patients' index of glycosylated hemoglobin (HbA1c) improved after 12 months of intervention (MD = - 0.84; 95% CI = - 1.53, - 0.16; Z = 2.42; P = 0.02), and no significant differences in fasting blood glucose (FBG) levels were observed after 6 months of intervention (MD = - 0.35; 95% CI = - 0.75,0.06; Z = 1.69; P = 0.09). The results also showed that systolic blood pressure (MD = - 6.71; 95% CI = - 11.40, - 2.02; Z = 2.81; P = 0.005) was reduced after 6 months of intervention.

Conclusion: Telemedicine had a positive effect on the management of diabetes, hypertension, and rheumatoid arthritis, especially when telemedicine consultation and telemonitoring method were used. When telemedicine was used as a disease management tool for patients with diabetes, the optimal intervention time is 12 months. Telemedicine improved the systolic blood pressure in hypertensive patients while also reducing negative emotions and enhancing medication adherence in rheumatoid arthritis patients.

Keywords: Diabetes; Hypertension; Meta-analysis; Rheumatoid arthritis; Systematic review; Telemedicine.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Telemedicine model diagram
Fig. 2
Fig. 2
Literature screening flow chart
Fig. 3
Fig. 3
Chart of quality risk assessment of related literature
Fig. 4
Fig. 4
Forest plots of glycosylated hemoglobin after 6 months of intervention between the intervention group and the control group
Fig. 5
Fig. 5
Forest plots of glycosylated hemoglobin after 12 months of intervention between the intervention group and the control group
Fig. 6
Fig. 6
Forest plots of fasting blood glucose after 6 months of intervention between the intervention group and the control group
Fig. 7
Fig. 7
Forest plots of the systolic blood pressure after 6 months of intervention between the intervention group and the control group
Fig. 8
Fig. 8
Forest plots of diastolic blood pressure after 6 months of intervention between the intervention group and the control group
See this image and copyright information in PMC

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