目标:确定与传统的面对面交付模式相比,使用远程医疗提供的联合健康干预措施是否为患者提供了相似或更好的结果。研究设计:使用Cochrane方法提取符合条件的随机试验的快速系统评价。符合条件的试验:如果将相当剂量的面对面干预与神经心理学家提供的远程健康干预进行比较,则试验有资格纳入。职业治疗师,物理治疗师,足病医生,心理学家,和/或言语病理学家;报告患者水平的结果;包括成年参与者。数据来源:MEDLINE,中部,CINAHL,和EMBASE数据库从一开始就进行系统评价,并从这些系统评价中提取符合条件的试验.然后在这些数据库中搜索每个学科(2017年)的最新系统评价搜索日期后发表的随机临床试验。还对纳入试验的参考列表进行了手工搜索,以确定可能遗漏的试验。使用Cochrane偏差风险工具第1版评估偏差风险。数据综合:52项试验(62份报告,n=4470)符合纳入标准。人群包括患有肌肉骨骼疾病的成年人,中风,创伤后应激障碍,抑郁症,和/或疼痛。同步和异步远程医疗方法被使用,包括电话,视频会议,应用程序,Web门户,和远程监控,总的来说,远程医疗为膝盖范围的面对面干预提供了类似的改进,与健康相关的生活质量,疼痛,语言功能,抑郁症,焦虑,创伤后应激障碍。此荟萃分析仅限于某些结果和学科,例如职业治疗和言语病理学。远程医疗是安全的,与面对面干预相比,不同的交付方式和学科的满意度和依从性水平相似。结论:通过远程医疗提供的许多联合健康干预措施与面对面一样有效。将远程医疗纳入护理模式可能会增加与专职医疗专业人员的接触,然而,仍需要进一步的比较研究。特别是,我们对足病医生对远程医疗功效的理解存在显著差距,职业治疗师,言语病理学家,和神经心理学家。协议注册编号:PROSPERO(CRD42020203128)。
Objectives: To determine whether allied health interventions delivered using telehealth provide similar or better outcomes for patients compared with traditional face-to-face delivery modes. Study design: A rapid systematic review using the Cochrane methodology to extract eligible randomized trials. Eligible trials: Trials were eligible for inclusion if they compared a comparable dose of face-to-face to telehealth interventions delivered by a neuropsychologist, occupational therapist, physiotherapist, podiatrist, psychologist, and/or speech pathologist; reported patient-level outcomes; and included adult participants. Data sources: MEDLINE, CENTRAL, CINAHL, and EMBASE databases were first searched from inception for systematic reviews and eligible trials were extracted from these systematic reviews. These databases were then searched for randomized clinical trials published after the date of the most recent systematic review search in each discipline (2017). The reference lists of included trials were also hand-searched to identify potentially missed trials. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 1. Data Synthesis: Fifty-two trials (62 reports, n = 4470) met the inclusion criteria. Populations included adults with musculoskeletal conditions, stroke, post-traumatic stress disorder, depression, and/or pain. Synchronous and asynchronous telehealth approaches were used with varied modalities that included telephone, videoconferencing, apps, web portals, and remote monitoring, Overall, telehealth delivered similar improvements to face-to-face interventions for knee range, Health-Related Quality of Life, pain, language function, depression, anxiety, and Post-Traumatic Stress Disorder. This meta-analysis was limited for some outcomes and disciplines such as occupational therapy and speech pathology. Telehealth was safe and similar levels of satisfaction and adherence were found across modes of delivery and disciplines compared to face-to-face interventions. Conclusions: Many allied health interventions are equally as effective as face-to-face when delivered via telehealth. Incorporating telehealth into models of care may afford greater access to allied health professionals, however further comparative research is still required. In particular, significant gaps exist in our understanding of the efficacy of telehealth from podiatrists, occupational therapists, speech pathologists, and neuropsychologists. Protocol Registration Number: PROSPERO (CRD42020203128).