Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Metadatos
Mostrar el registro completo del ítemEditorial
MDPI
Materia
Chronic diseases Hypertension Older Telehealth Telemedicine
Fecha
2023-09-24Referencia bibliográfica
Quesada-Caballero, M.; Carmona-García, A.; Chami-Peña, S.; Caballero-Mateos, A.M.; Fernández- Martín, O.; Cañadas-De la Fuente, G.A.; Romero-Bejar, J.L. Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. J. Clin. Med. 2023, 12, 6160. [https://doi.org/ 10.3390/jcm12196160]
Resumen
Background: One aspect of the distancing measures imposed in response to the COVID-19
pandemic is that telemedicine consultations have increased exponentially. Among these consultations,
the assessment and follow-up of patients with chronic diseases in a non-presential setting has been
strengthened considerably. Nevertheless, some controversy remains about the most suitable means
of patient follow-up. Objective: To analyze the impact of the telemedicine measures implemented
during the COVID-19 period on chronic patients. Material and Methods: A systematic review
was carried out using the following databases: PubMed, Pro-Quest, and Scopus. The systematic
review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA). The search equation utilized descriptors sourced from the Medical Subject
Headings (MeSH) thesaurus. The search equation was: “hypertension AND older AND primary
care AND (COVID-19 OR coronavirus)” and its Spanish equivalent. Results: The following data
were obtained: 14 articles provided data on 6,109,628 patients and another 4 articles focused on a
study population of 9684 physicians. Telemedicine was less likely to be used by elderly patients
(OR 0.85; 95% C.I. 0.83–0.88; p = 0.05), those of Asian race (OR 0.69; 95% C.I. 0.66–0.73; p = 0.05), and
those whose native language was not English (OR 0.89; 95% C.I. 0.78–0.9; p = 0.05). In primary care,
lower use of telemedicine was associated with residents of rural areas (OR 0.81; p = 0.05), patients of
African American race (OR 0.65, p = 0.05), and others (OR 0.64; p = 0.05). A high proportion (40%) of
physicians had no prior training in telemedicine techniques. The highest quality in terms of telephone
consultation was significantly associated with physicians who did not increase their prescription of
antibiotherapy during the pandemic (OR = 0.30, p = 0.05) or prescribe more tests (OR 0.06 p = 0.05),
i.e., who maintained their former clinical criteria despite COVID-19. Conclusions: Telemedicine is of
proven value and has been especially useful in the COVID-19 pandemic. A mixed remote–presential
model is most efficient. Appropriate training in this area for physicians and patients, together with
correct provision, is essential to prevent errors in implementation and use