만성폐쇄성폐질환에서 원격의료 중재의 체계적 문헌고찰 개관
An Overview of Systematic Reviews of Telehealth Intervention for Chronic Obstructive Pulmonary Disease
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Objectives: The aim of this overview was to synthesize the current evidence of published systematic reviews (SRs) addressing telehealth intervention for chronic obstructive pulmonary disease (COPD). Methods: We searched 3 databases (MEDLINE, EMBASE, and Cochrane Library) up to March 2016. By two authors independently, SRs were selected based on predefined inclusion criteria. Only English or Korean articles published after 2010 were selected. The outcomes of interest were clinical outcome (i.e., exacerbation events, dyspnea scale, health-related quality of life, mortality, and healthcare utilization), associated costs and factors influencing the adoption of telehealth. Narrative analysis was conducted. Results: Of the 147 articles, 13 SRs of telehealth met all inclusion criteria. Most of the control groups were offered usual care. Overall, there were no clinical variables reported consistent improvements in telehealth group compared with control group. With regard to quality of life outcomes, it was found that telehealth group showed statistically significant improvement than control group. As a result of analyzing hospitalization and medical costs, the decreasing tendency appeared in telehealth group compared with control group. In the studies explored factors affecting the adoption of telehealth, some barriers and facilitators in telehealth uptake were suggested. Conclusion: Possible beneficial effects were observed for telehealth of COPD patients in some of the outcomes. However, the detailed interventions differed between studies. This is an important area of research and further studies regarding impacts of telehealth for COPD management would be needed.
Abstract
Objectives: The aim of this overview was to synthesize the current evidence of published systematic reviews (SRs) addressing telehealth intervention for chronic obstructive pulmonary disease (COPD). Methods: We searched 3 databases (MEDLINE, EMBASE, and Cochrane Library) up to March 2016. By two authors independently, SRs were selected based on predefined inclusion criteria. Only English or Korean articles published after 2010 were selected. The outcomes of interest were clinical outcome (i.e., exacerbation events, dyspnea scale, health-related quality of life, mortality, and healthcare utilization), associated costs and factors influencing the adoption of telehealth. Narrative analysis was conducted. Results: Of the 147 articles, 13 SRs of telehealth met all inclusion criteria. Most of the control groups were offered usual care. Overall, there were no clinical variables reported consistent improvements in telehealth group compared with control group. With regard to quality of life outcomes, it was found that telehealth group showed statistically significant improvement than control group. As a result of analyzing hospitalization and medical costs, the decreasing tendency appeared in telehealth group compared with control group. In the studies explored factors affecting the adoption of telehealth, some barriers and facilitators in telehealth uptake were suggested. Conclusion: Possible beneficial effects were observed for telehealth of COPD patients in some of the outcomes. However, the detailed interventions differed between studies. This is an important area of research and further studies regarding impacts of telehealth for COPD management would be needed.
참고문헌 (21)
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