The effect of telehealth versus usual care for home-care patients with long-term conditions: a systematic review, meta-analysis and qualitative synthesis
Open accessAbstract
Introduction: Approximately 26 million people in the United Kingdom are living with one long-term condition and 10 million are living with two or more; these figures are projected to continue increasing (NHS England 2018). People with long-term conditions are two to three times more likely to have poor psychological wellbeing and utilise 50% of GP appointments, 64% of outpatient appointments and over 70 of inpatient bed days. Research in this population could help with increasing constraints on healthcare budgets and resources. Technology-enabled healthcare in the community might help improve quality of life and reduce healthcare costs of managing chronic disease but the overall impact is unclear, we therefore conducted a systematic review. Methods: Keywords and MeSH terms were used to search MEDLINE and CINAHL. We included qualitative and quantitative studies that reported on adult home-care patients diagnosed with at least one long-term condition, comparing telehealth to usual home care. Meta-analyses and sensitivity analyses were conducted using RevMan 5. Qualitative findings were thematically synthesised and reported narratively. Results: In total, 2568 studies were identified and nine (2611 participants) were included. Telehealth was not statistically significantly different versus standard home care for quality of life, psychological wellbeing, physical function, anxiety, depression, disease specific outcomes or bed days of care at 3, 6, 9 and 12 months. Qualitative findings showed patients found telehealth was beneficial for providing peace of mind and legitimising access to healthcare. Conclusion: Telehealth may offer reassurance to those living in the community with long-term conditions; however, a lack of high-quality studies and heterogeneity between interventions makes conclusions difficult.
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Qualitative studies had indicated high patient and staff satisfaction but frequent technical problems.
“Qualitative studies had indicated high patient and staff satisfaction but frequent technical problems (113–115)”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [113]
Almost all primary studies of video versus face-to-face appointments were underpowered and had highly-selected samples.
“almost all primary studies were underpowered and had highly-selected samples”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [113]
Patients randomized to video did no worse clinically and were no less satisfied than those randomized to usual care, and costs where measured were similar.
“Overall, patients randomized to video did no worse clinically and were no less satisfied than those randomized to usual care, and that costs (where measured) were similar”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [113]
Dozens of randomized controlled trials have compared video with face-to-face appointments in low-risk patients with stable long-term conditions.
“there have been dozens of randomized controlled trials comparing video with face to face appointments in low-risk patients with stable long-term conditions (109–114)”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [113]
These findings confirm previous reviews while expanding the results to populations outside care homes and including study designs other than RCTs.
“Our findings confirm previous reviews [177,178] while expanding the results to populations outside care homes [178] and including study designs other than RCTs [177].”
From Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis (2022) · cites this paper as [178]
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- Authors
- McFarland, S., Coufopolous, A., & Lycett, D.
- Affiliations
- Coventry University (GB)
- Corresponding author
- McFarland, Sophie
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2019-08-08
- Volume
- 27
- Issue
- 2
- Pages
- 69-87
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W2947113171
- Cited by
- 52
- References
- 18
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 16 · 2022: 8 · 2021: 8 · 2020: 2 · 2019: 3
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Telemedicine and Telecare (publishedVersion)
- PubMed (publishedVersion)
- Pure (Coventry University) (submittedVersion, other-oa)
- Pure (Coventry University) (submittedVersion)
- Funders
- Coventry University
- Interserve Healthcare
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- telemedicine, home care, chronic disease, usual care, quality of life, psychological well-being, anxiety, depression, physical function, health care utilization, community-based care, patient experience
- MeSH terms
- Adult, Anxiety, Chronic Disease, United Kingdom, Home Care Services, Humans, Quality of Life, Telemedicine, Disease Management
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