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Cited by 50Telemedicine and Telehealth ImplementationMobile Health and mHealth ApplicationsTechnology Use by Older Adults

Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis

Open access
Creber, Anna, Leo, Donato Giuseppe, Buckley, Benjamin J. R., Chowdhury, Mahin, Harrison, Stephanie L., Isanejad, Masoud, Lane, Deirdre A., on behalf of the TAILOR investigators·2023·BMC Cardiovascular Disorders
DOI 10.1186/s12872-023-03486-3PMC PMC10510185
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Abstract

Background: Telemonitoring for the remote patient self-management of chronic conditions can be a cost-effective method for delivering care in chronic disease; nonetheless, its implementation in clinical practice remains low. The aim of this meta-synthesis is to explore barriers and facilitators associated with the use of remote patient monitoring of chronic disease, drawing on qualitative research, and assessing participant interactions with this technology. Method: A meta-synthesis of qualitative studies was performed. MEDLINE, SCOPUS and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database date of inception to 5 February 2021. The Critical Appraisal Skills Programme (CASP) was used to critically appraise each study. Thematic synthesis was performed to identify user (patients, carers and healthcare professionals) perspectives and experiences of patient remote monitoring of chronic disease (Type 2 diabetes mellitus, chronic obstructive pulmonary disease, and cardiovascular disease). Results: Searches returned 10,401 studies and following independent screening by two reviewers, nine studies were included in this meta-synthesis. Data were synthesised and categorised into four key themes: (1) Improved care ; (2) Communication ; (3) Technology feasibility & acceptability ; and (4) Intervention concerns . Most patients using patient remote devices felt motivated in managing their own lifestyles and felt reassured by the close monitoring and increased communication. Barriers identified involved generational differences and difficulties with the technology used. Conclusion: Most studies showed a positive attitude to telemonitoring, with patients preferring the convenience of telemonitoring in comparison to attending regular clinics. Further research is required to assess the most effective technology for chronic disease management, how to maintain long-term patient adherence, and identify effective approaches to address generational variation in telemonitoring up-take.

AI snapshot

Written from the paper’s full text.

TL;DR

This qualitative meta-synthesis found that telemonitoring for chronic disease self-management was generally feasible and acceptable, with patients often preferring its convenience and feeling reassured by closer monitoring and communication. Barriers included technology difficulties, generational differences, privacy concerns, and limited long-term evidence.

Key findings

  • Searches returned 10,401 studies; after duplicate removal 9,579 remained, 128 full texts were reviewed, and 9 qualitative studies were included.
  • Data were synthesised into four themes: (1) Improved care; (2) Communication; (3) Technology feasibility & acceptability; and (4) Intervention concerns.
  • Most patients felt motivated to manage their lifestyles and reassured by close monitoring and increased communication; barriers included generational differences and difficulties with the technology used.
  • Concerns about privacy and security of personal data were reported, and the paper notes this was not seen in other meta-syntheses.

Methods

  • A meta-synthesis of qualitative studies was performed, registered on PROSPERO (CRD42021236291) and reported according to PRISMA.
  • MEDLINE, SCOPUS, and Cochrane CENTRAL were searched from inception to 5 February 2021; two reviewers independently screened studies, and CASP was used for quality assessment.
  • Eligible studies included adults aged 18+ with COPD, cardiovascular disease, and/or diabetes mellitus, plus HCP/carer views if available; thematic synthesis identified user perspectives and experiences.

Limitations

  • The paper states that included studies reported barriers/facilitators of the whole intervention but not enough on individual intervention components; the low number of studies may affect generalisability, especially as most were from the UK and USA; the wide variety of interventions may have impacted results; and no grey literature search was conducted.
  • The paper also states that none of the included studies investigated telemonitoring over a long timeframe, making it difficult to assess sustained engagement and motivation.
  • Evident from the text: all nine studies were rated “can’t tell” for consideration of the patient–researcher relationship, most had insufficient ethical-detail reporting, and three had unclear recruitment strategies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12872-023-03486-3

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 125 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Most patients using patient remote devices felt motivated in managing their own lifestyles.

    “Most patients using patient remote devices felt motivated in managing their own lifestyles and felt reassured by the close monitoring and increased communication.”
    Quote in the paperSubstantial claim
  • Findingown data

    Nine qualitative studies were identified and included in the meta-synthesis.

    “Of these, nine qualitative studies [19–27] were identified and included in the meta-synthesis (Fig. 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    Most studies showed a positive attitude to telemonitoring.

    “Most studies showed a positive attitude to telemonitoring, with patients preferring the convenience of telemonitoring in comparison to attending regular clinics.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Telemonitoring facilitated communication between patient and healthcare professional.

    “Communication | Communication between patient & healthcare professional”
    Quote in the paperSubstantial claim
  • Findingcitation

    The 'improved care' theme was identified in seven of nine included studies.

    “The “improved care” theme was identified in seven of nine studies. [19–23, 25, 26]”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

    • cites [20] Baron JS, Hirani SP, Newman SP. Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: results of a randomized controlled trial with patient interviews. J Telemed Telecare. 2017;23(5):503–12. source

      Not checked in the free run.

    • cites [21] Beran M, Asche SE, Bergdall AR, Crabtree B, Green BB, Groen SE, Klotzle KJ, Michels RD, Nyboer RA, O’Connor PJ, et al. Key components of success in a randomized trial of blood pressure telemonitoring with medication therapy management pharmacists. J Am Pharm Assoc (2003). 2018;58(6):614–21. source

      Not checked in the free run.

    • cites [22] Grant S, Hodgkinson J, Schwartz C, Bradburn P, Franssen M, Hobbs FR, Jowett S, McManus RJ, Greenfield S. Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial. Br J Gen Pract. 2019;69(686):e612–20. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 45
  • May combine two claims. 50

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Length of intervention varied, with three studies investigating telemonitoring use over 12 months, and five with interventions lasting between one and nine months.

    “Length of the intervention in included studies varied, with three [21, 22, 24] investigating telemonitoring use over 12 months, and five [20, 23, 26, 27] with interventions lasting between one and nine months.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    A usual care comparator was used by six studies, but only the telemonitoring intervention groups were interviewed.

    “A usual care comparator was used by six studies, [20–24, 26] however only the telemonitoring intervention groups were interviewed. [20–24, 26]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    All studies collected data using semi-structured interviews (one unspecified), either alone or using additional focus groups or additional surveys.

    “All studies collected data using semi-structured interviews (one study had an unspecified interview type), [22] either alone or using additional focus groups [21, 24, 27] or additional surveys. [19]”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Telemonitoring increased patients' awareness of their health, leading them to make improved lifestyle changes.

    “Several patients expressed that telemonitoring increased their awareness of their health and consequently they made improved lifestyle changes. [19, 20, 23, 25, 26]”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

    • cites [20] Baron JS, Hirani SP, Newman SP. Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: results of a randomized controlled trial with patient interviews. J Telemed Telecare. 2017;23(5):503–12. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Types of telemonitoring interventions used varied: four studies used participants' mobile phones, two provided tablet computers, and two had home monitoring devices.

    “Types of telemonitoring interventions used in each study varied (Table 1): four studies used participant’s mobile phones for data transmission, [19, 20, 22, 24] two studies provided tablet computers [26, 27] and two had home monitoring devices. [21, 23]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Four studies focused only on patients' views, whereas the remaining studies included patient, pharmacist, HCPs and carer views.

    “Four studies focused only on patients’ views, [20, 24–26] whereas the remaining studies included patient, pharmacist, HCPs and carer views (see Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The remaining three studies were single groups with no comparator.

    “The remaining three studies were single groups with no comparator. [19, 25, 27]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Following duplicate removal, 9,579 studies remained.

    “Following duplicate removal, 9,579 studies remained.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The findings of the nine studies were categorised into four main themes and nine associated sub-themes.

    “The findings of the nine studies were categorised into four main (recurring) themes and a total of nine associated sub-themes (Fig. 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Most included studies were conducted in the UK and USA, with one in Malaysia and one in Denmark.

    “most were conducted in the UK, [20, 22, 23, 25] and in the USA, [19, 21, 27] with one study in Malaysia [24] and one study in Denmark. [26]”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The four main themes are: (1) Improved care; (2) Communication; (3) Technology feasibility & acceptability; and (4) Intervention concerns.

    “Data were synthesised and categorised into four key themes: (1) Improved care; (2) Communication; (3) Technology feasibility & acceptability; and (4) Intervention concerns.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included studies focused on diabetes (n=5), hypertension (n=3), and COPD (n=1).

    “The studies focused on the following diseases: diabetes (n = 5), [20, 23–25, 27] hypertension (n = 3), [19, 21, 22] and COPD (n = 1). [26]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One study recruited participants who had used/were using telemonitoring.

    “One study recruited participants who had used/were using telemonitoring. [25]”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    All included studies used either a qualitative or mixed methods approach.

    “All studies used either a qualitative [22–27] or mixed methods [19–21] approach.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The nine included studies were undertaken between 2015 and 2020.

    “Of these nine studies [19–27], undertaken between 2015 and 2020, [23, 27]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The database search initially identified 10,401 studies.

    “The database search initially identified 10,401 studies (including both quantitative and qualitative studies).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Studies predominantly used thematic analysis, with one study each using grounded theory analysis, Hamilton's rapid analysis, manifest and latent analysis, and phenomenological analysis.

    “Studies predominantly used thematic analysis [19, 20, 23, 24, 27] with one study each using grounded theory analysis, [23] Hamilton’s rapid analysis, [22] manifest and latent analysis [26] and phenomenological analysis. [25]”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    After screening titles and abstracts, 128 full text articles were reviewed.

    “After screening titles and abstracts, 128 full text articles were subsequently reviewed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    GPs reported improved communications from telemonitoring interventions, leading to enhanced doctor-patient relationships.

    “GPs reported improved communications resulting from telemonitoring interventions leading to “enhanced doctor-patient relationships”. [22]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Grant S, Hodgkinson J, Schwartz C, Bradburn P, Franssen M, Hobbs FR, Jowett S, McManus RJ, Greenfield S. Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial. Br J Gen Pract. 2019;69(686):e612–20. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Views on communication were inconsistent across studies; some patients found communication difficult or received minimal patient/HCP contact.

    “However, this view was inconsistent across studies; for example, some patients found communication difficult [25] or received minimal patient/HCP contact. [23]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Telemonitoring led to increased understanding of disease, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring, and improved oxygen saturation monitoring.

    “Three studies [12, 20, 26] mentioned an increased understanding of their disease through telemonitoring, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring [20] and improved oxygen saturation monitoring. [12, 26].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [12] Brunton L, Bower P, Sanders C. The contradictions of Telehealth user experience in Chronic Obstructive Pulmonary Disease (COPD): a qualitative Meta-synthesis. PLoS ONE. 2015;10(10):e0139561. source

      Not checked in the free run.

    • cites [20] Baron JS, Hirani SP, Newman SP. Investigating the behavioural effects of a mobile-phone based home telehealth intervention in people with insulin-requiring diabetes: results of a randomized controlled trial with patient interviews. J Telemed Telecare. 2017;23(5):503–12. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    A nurse in the same study felt telemonitoring led to faster treatment changes, a view shared by participants in another included study.

    “However, in direct contrast, a nurse participating in the same study felt the telemonitoring intervention led to faster treatment changes; [23] a view shared by the participants of another included study. [26].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Findingcitation

    Another GP stated that telemonitoring interventions would not alter medication administration.

    “Another GP stated that telemonitoring interventions would not alter medication administration. [23]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Instant feedback and communication back and forth improved patient-professional relationships, with patients able to open up more regarding their health issues.

    “The result of “instant feedback” and “communication back and forth” improved patient-professional relationships [21] with patients able to ‘open-up’ more regarding their health issues. [26]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] Beran M, Asche SE, Bergdall AR, Crabtree B, Green BB, Groen SE, Klotzle KJ, Michels RD, Nyboer RA, O’Connor PJ, et al. Key components of success in a randomized trial of blood pressure telemonitoring with medication therapy management pharmacists. J Am Pharm Assoc (2003). 2018;58(6):614–21. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The technology acceptability and feasibility theme arose in six studies and comprised three sub-themes: convenience and acceptability, technology feasibility, and barriers of rural areas.

    “This theme arose in six studies [19, 22–25, 27] and comprise the following sub-themes: (1) Convenience & Acceptability; (2) Technology feasibility; and (3) Barriers of rural areas.”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

    • cites [22] Grant S, Hodgkinson J, Schwartz C, Bradburn P, Franssen M, Hobbs FR, Jowett S, McManus RJ, Greenfield S. Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial. Br J Gen Pract. 2019;69(686):e612–20. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [24] Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, Nasir N, Lee SWH. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9(10):e026575. source

      Not checked in the free run.

    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

    • cites [27] Pekmezaris R, Williams MS, Pascarelli B, Finuf KD, Harris YT, Myers AK, Taylor T, Kline M, Patel VH, Murray LM, et al. Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptability and feasibility study. BMC Med Inform Decis Mak. 2020;20(1):324. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One pharmacist described a potential danger of prescribing additional medication without frequent face-to-face follow-ups.

    “One pharmacist described a potential danger of prescribing additional medication without frequent face-to-face follow-ups. [19]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Pharmacists observed making more responsive medication changes and individually tailored treatment plans through better-informed decisions.

    “Several pharmacists observed making more responsive medication changes and individually tailored treatment plans through better-informed decisions. [21]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Beran M, Asche SE, Bergdall AR, Crabtree B, Green BB, Groen SE, Klotzle KJ, Michels RD, Nyboer RA, O’Connor PJ, et al. Key components of success in a randomized trial of blood pressure telemonitoring with medication therapy management pharmacists. J Am Pharm Assoc (2003). 2018;58(6):614–21. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    While five studies identified clear benefits of telemonitoring, some healthcare professionals highlighted potential drawbacks concerning treatments.

    “Whilst five studies [19, 21–23, 26] identified clear benefits of telemonitoring, some HCPs highlighted potential drawbacks concerning treatments.”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

    • cites [21] Beran M, Asche SE, Bergdall AR, Crabtree B, Green BB, Groen SE, Klotzle KJ, Michels RD, Nyboer RA, O’Connor PJ, et al. Key components of success in a randomized trial of blood pressure telemonitoring with medication therapy management pharmacists. J Am Pharm Assoc (2003). 2018;58(6):614–21. source

      Not checked in the free run.

    • cites [22] Grant S, Hodgkinson J, Schwartz C, Bradburn P, Franssen M, Hobbs FR, Jowett S, McManus RJ, Greenfield S. Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial. Br J Gen Pract. 2019;69(686):e612–20. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In studies where doctors were not the main contact points, there was a lack of communication between staff, with patients repeating themselves to different staff members and perceiving that HCPs were not working together with those monitoring the readings.

    “Some studies in which doctors were not the main contact points reported a “lack of communication between staff’’, [25] with patients repeating themselves to different staff members, resulting in the perception that HCPs were “not working together” with those monitoring the readings. [25]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Patients commonly reported enjoying not having to attend surgery so often while being more regularly monitored.

    “Patients commonly reported enjoying not having to attend surgery so often whilst being more regularly monitored. [23, 24]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [24] Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, Nasir N, Lee SWH. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9(10):e026575. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Some participants, both HCPs and patients, thought telemonitoring was fantastic, finding it easy and quick to access, particularly compared to the difficulties of phoning doctors.

    “Some participants (both HCPs and patients) thought using telemonitoring was “fantastic”, [22] finding it easy and quick to access, particularly in comparison to the difficulties of phoning doctors. [25]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [22] Grant S, Hodgkinson J, Schwartz C, Bradburn P, Franssen M, Hobbs FR, Jowett S, McManus RJ, Greenfield S. Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial. Br J Gen Pract. 2019;69(686):e612–20. source

      Not checked in the free run.

    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In three studies, participants found devices difficult to use, accentuated by generational differences, with older participants generally less confident and less able to use them.

    “In three studies, [19, 23, 27] participants found devices difficult to use, which was accentuated by generational differences, with older participants generally less confident and less able to use them.”
    • Also stated in: § Conclusion · plain
      “Additional barriers to telemonitoring uptake include an ongoing unfamiliarity with technologies being used, particularly for older people.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

    • cites [23] Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, Sheikh A, Wild S, McKinstry B. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ open. 2015;5:e008896. source

      Not checked in the free run.

    • cites [27] Pekmezaris R, Williams MS, Pascarelli B, Finuf KD, Harris YT, Myers AK, Taylor T, Kline M, Patel VH, Murray LM, et al. Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptability and feasibility study. BMC Med Inform Decis Mak. 2020;20(1):324. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Some patients were unhappy with having to self-monitor so often and were unsure how it would be maintained in the longer term.

    “However, some patients were unhappy with having to self-monitor so often and were unsure how it would be maintained in the longer-term. [19]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Some participants did not feel comfortable discussing psychological aspects of their disease via video-call, feeling it was less personal, and reported distress when the internet signal was poor or interrupted.

    “However, some other participants did not feel comfortable talking about the psychological aspects of their disease via video-call, as they felt this approach was less “personal”, and they also reported distress when the internet signal was poor or interrupted during the call.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A physician described that self-monitoring programs needed to be very simplistic, especially for older patients.

    “A physician described that self-monitoring programs needed to be “very simplistic, especially for older patients”. [19]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Consideration of cultural differences was highlighted when creating educational videos, as many patients felt the content and/or technology were not culturally appropriate, particularly for the Hispanic and Latino population.

    “Consideration of cultural differences was highlighted when creating educational videos to supplement the device/application, as many patients felt the content and/or technology were not “culturally appropriate”, particularly targeting the Hispanic and Latino population [27].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Pekmezaris R, Williams MS, Pascarelli B, Finuf KD, Harris YT, Myers AK, Taylor T, Kline M, Patel VH, Murray LM, et al. Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptability and feasibility study. BMC Med Inform Decis Mak. 2020;20(1):324. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In one study, multiple participants found difficulties syncing blood pressure results to their phone, while others had no problems with the telemedicine programme.

    “In one study, [19] multiple participants found difficulties in syncing blood pressure results to their phone, whilst others had “no problems with the (telemedicine) programme”.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    In one study, some individuals felt video consultations were safer and more relaxed than clinics and avoided the travel required to access the clinic in person.

    “In this study some individuals felt video consultations were safer and more relaxed than clinics and avoided the travel required to access the clinic in person).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Nissen L, Lindhardt T. A qualitative study of COPD-patients’ experience of a telemedicine intervention. Int J Med Inform. 2017;107:11–7. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Concerns over data input error were highlighted due to patients manually typing in readings, implying that devices able to automate data transfer might be better.

    “Concerns over data input error were highlighted due to patients manually typing in readings, with the implication that devices able to automate data transfer might be better. [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Buis LR, Roberson DN, Kadri R, Rockey NG, Plegue MA, Danak SU, Guetterman TC, Johnson MG, Choe HM, Richardson CR. Understanding the feasibility, acceptability, and efficacy of a clinical pharmacist-led Mobile Approach (BPTrack) to Hypertension Management: mixed methods pilot study. J Med Internet Res. 2020;22(8):e19882. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    One older patient contradicted views that older patients cannot use devices, suggesting that improved device education and training is likely to directly correlate with telemonitoring take-up.

    “Nonetheless, one older patient contradicted these views, explaining that “as long as someone shows me… I can do it.”, [24] suggesting that improvement to device education and training is likely to directly correlate with telemonitoring take-up.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, Nasir N, Lee SWH. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9(10):e026575. source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Most participants had positive experiences from telemonitoring usage, with most reporting it is more convenient than attending in-person clinics.

    “Most participants had positive experiences from telemonitoring usage, with most reporting that it is more convenient than attending in-person clinics.”
    • Also stated in: § Conclusion · plain
      “Most participants preferred the convenience of telemonitoring in comparison to attending in-person clinics and took comfort from increased communication with HCPs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Many HCPs and patients believed telemonitoring saved healthcare time and resources and improved communication.

    “Many HCPs and patients supported this view, believing telemonitoring saved healthcare time/resource and improved communication.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The importance of education regarding device usage was highlighted in three studies, though this is likely dependent on the specific devices used.

    “Whilst this is likely to be dependent on specific devices used, the importance of education regarding device usage was highlighted in three studies. [24, 25, 27]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [24] Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, Nasir N, Lee SWH. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9(10):e026575. source

      Not checked in the free run.

    • cites [25] Lee PA, Greenfield G, Pappas Y. Patients’ perception of using telehealth for type 2 diabetes management: a phenomenological study. BMC Health Serv Res. 2018;18(1):549. source

      Not checked in the free run.

    • cites [27] Pekmezaris R, Williams MS, Pascarelli B, Finuf KD, Harris YT, Myers AK, Taylor T, Kline M, Patel VH, Murray LM, et al. Adapting a home telemonitoring intervention for underserved Hispanic/Latino patients with type 2 diabetes: an acceptability and feasibility study. BMC Med Inform Decis Mak. 2020;20(1):324. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Participants in one study were concerned about poor internet connectivity in certain villages, suggesting that technology feasibility may depend on available digital infrastructure, limiting its usability.

    “However, participants in one study [24] were concerned about poor internet connectivity in certain villages, suggesting the results regarding technology feasibility may be dependent on the available digital infrastructure, thereby limiting its usability.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, Nasir N, Lee SWH. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9(10):e026575. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Our findings align with two other studies reporting that telemonitoring is likely to improve patients' self-care and sense of security.

    “Indeed, our findings align with two other studies reporting that telemonitoring is likely to improve patients’ self-care [28] and sense of security. [12]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Slater H, Campbell JM, Stinson JN, Burley MM, Briggs AM. End user and implementer experiences of mHealth Technologies for Noncommunicable Chronic Disease Management in Young adults: systematic review. J Med Internet Res. 2017;19(12):e406. source

      Not checked in the free run.

    • cites [12] Brunton L, Bower P, Sanders C. The contradictions of Telehealth user experience in Chronic Obstructive Pulmonary Disease (COPD): a qualitative Meta-synthesis. PLoS ONE. 2015;10(10):e0139561. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Telemonitoring can be an acceptable and cost-effective method for delivering effective care for people with chronic diseases.

    “Telemonitoring can be an acceptable and cost-effective method for delivering effective care for people with chronic diseases. [4]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Ryu S. Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth 2009. Healthc Inf Res. 2012;2(2):153–5. (Global Observatory for eHealth Series. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Telemonitoring implementation within the UK has been slow.

    “Telemonitoring implementation within the UK has been slow, but it has increased during the Coronavirus disease (COVID-19) pandemic. [3, 8]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3] DH/Long Term Conditions. Long Term Conditions Compendium of Information: Third Edition. In. Edited by Care DoHaS, Third edn. Department of Health: Department of Health; 2012.

      Not checked in the free run.

    • cites [8] Bidmead E, Marshall A. Covid-19 and the ‘new normal’: are remote video consultations here to stay? Br Med Bull. 2020;135(1):16–22. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Full text for each relevant study was independently assessed for eligibility criteria.

    “Full text for each relevant study was retrieved and independently assessed for eligibility criteria.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Three studies were assessed as 'can't tell' regarding use of an appropriate recruitment strategy.

    “Three studies [19, 20, 27] were assessed as ‘can’t tell’ regarding use of an appropriate recruitment strategy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Insufficient details concerning patient-researcher relationship were seen in all nine studies, resulting in 'can't tell' for this area.

    “However, insufficient details concerning patient-researcher relationship was seen in all nine studies, [19–27] resulting in the choice of ‘can’t tell’ being selected for this area.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A barrier for patients to telemonitoring is unfamiliarity and difficulties in technology access due to generational differences, with older patients experiencing more difficulties interacting with new technologies.

    “Broader barriers for patients include unfamiliarity and difficulties in technology access due to generational differences (where older patients experiences more difficulties in interacting with new technologies) and poor digital literacy, [9] and poor internet connectivity. [10]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. 2018;24(1):4–12. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    No studies were excluded due to low-quality or unreliable research, with each study equally considered.

    “No studies were excluded due to low-quality or unreliable research, with each study equally considered.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Two researchers independently assessed study validity and credibility using the CASP qualitative checklist tool.

    “Two researchers (AC, DGL) independently assessed study validity and credibility using the Critical Appraisal Skills Programme (CASP) qualitative checklist tool. [17]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Critical Appraisal Skills Programme. (2018). [https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist2018.pdf].

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review was conducted in accordance with PRISMA guidelines.

    “The review was registered on the International Prospective Register of Systematic Reviews – PROSPERO (CRD42021236291) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    From HCPs' point of view, a barrier toward telemonitoring is concerns with data protection.

    “From the HCPs point of view, barriers toward this technology focus on the concerns with data protection, and on worries that telemonitoring may disrupt patient-doctor interaction. [11]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Wernhart A, Gahbauer S, Haluza D. eHealth and telemedicine: Practices and beliefs among healthcare professionals and medical students at a medical university. PLoS ONE. 2019;14(2):e0213067. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Discrepancies in screening were resolved through consultation/review with the senior author.

    “Discrepancies were resolved through consultation/review with the senior author (DAL).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In another study, it was unclear how patients were selected.

    “In another study [19], it was also unclear how patients were selected.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The last study provided no explanation on participant recruitment.

    “The last study [27] provided no explanation on participant recruitment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Telemonitoring implementation within the UK increased during the COVID-19 pandemic.

    “Telemonitoring implementation within the UK has been slow, but it has increased during the Coronavirus disease (COVID-19) pandemic. [3, 8]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3] DH/Long Term Conditions. Long Term Conditions Compendium of Information: Third Edition. In. Edited by Care DoHaS, Third edn. Department of Health: Department of Health; 2012.

      Not checked in the free run.

    • cites [8] Bidmead E, Marshall A. Covid-19 and the ‘new normal’: are remote video consultations here to stay? Br Med Bull. 2020;135(1):16–22. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Selected study titles and abstracts were independently screened by two reviewers against agreed inclusion criteria.

    “After removal of duplicates, selected study titles and abstracts were independently screened by two reviewers (DGL, MC) against agreed inclusion criteria.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review was registered on PROSPERO (CRD42021236291).

    “The review was registered on the International Prospective Register of Systematic Reviews – PROSPERO (CRD42021236291) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    It was unclear in one study how many participants from the randomised control trial agreed to be interviewed and how these were recruited.

    “It was unclear in one study [20] how many participants from the randomised control trial agreed to be interviewed and how these were recruited.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    From HCPs' point of view, a barrier toward telemonitoring is worries that telemonitoring may disrupt patient-doctor interaction.

    “From the HCPs point of view, barriers toward this technology focus on the concerns with data protection, and on worries that telemonitoring may disrupt patient-doctor interaction. [11]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Wernhart A, Gahbauer S, Haluza D. eHealth and telemedicine: Practices and beliefs among healthcare professionals and medical students at a medical university. PLoS ONE. 2019;14(2):e0213067. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Discrepancies in quality assessment were discussed between researchers and unresolved were addressed by the senior author.

    “Discrepancies were discussed between researchers and those unresolved were addressed by the senior author (DAL).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The remaining studies had intervention lengths between one and 12 months, making it difficult to assess whether patients would remain permanently engaged and motivated to self-manage their diseases over a sustained period.

    “Of the remaining studies, length of the intervention was between one and 12 months, making therefore difficult to assess whether patients would remain permanently engaged and motivated to self-manage their disease(s) over a sustained period of time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Telemonitoring is both feasible and acceptable for chronic health condition management.

    “Results from this meta-synthesis suggest that telemonitoring is both feasible and acceptable for chronic health condition management.”
    • Also stated in: § Conclusion · hedged
      “This meta-synthesis of telemonitoring user perceptions in managing chronic disease suggests that telemonitoring is both feasible and acceptable.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Educational videos supplemented telemonitoring and gave patients the necessary information to make lifestyle changes, which may lead to better patient health outcomes.

    “This, supplemented with educational videos, gave patients the necessary information to make these lifestyle changes, which may lead to better patient health outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Telemonitoring may be a useful tool to support clinical practice, which may lead to improved patient satisfaction and care.

    “Our findings suggest that telemonitoring may be a useful tool to support clinical practice, which may lead to improved patient satisfaction and care.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The low number of studies included may affect the generalizability of the findings, particularly as included studies were mostly conducted in the UK and USA.

    “Furthermore, the low number of studies included in this meta-synthesis may affect the generalizability of the findings’, particularly as included studies were mostly conducted in the UK and USA.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The results may therefore be more generalizable and provide stronger evidence for implications for clinical practice.

    “The results may therefore be more generalizable and provide stronger evidence for implications for clinical practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Another meta-synthesis identified telemonitoring uptake being constrained by various technological issues associated with equipment usage.

    “Another meta-synthesis identified telemonitoring uptake being constrained by various technological issues associated with equipment usage. [12]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Brunton L, Bower P, Sanders C. The contradictions of Telehealth user experience in Chronic Obstructive Pulmonary Disease (COPD): a qualitative Meta-synthesis. PLoS ONE. 2015;10(10):e0139561. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Rigorous quality assessment was employed, with two reviewers independently screening for inclusion/exclusion criteria and independently assessing for risk of bias with an appropriate tool.

    “Rigorous quality assessment was employed, with two reviewers independently screening for inclusion/exclusion criteria and independently assessing for risk of bias with an appropriate tool.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The inclusion criteria of this meta-synthesis encompass more than one chronic disease and had few exclusion criteria, unlike previous meta-syntheses.

    “The inclusion criteria of this meta-synthesis encompass more than one chronic disease and had few exclusion criteria, unlike previous meta-syntheses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationown data

    The information gathered provided a good overview of the difficulties encountered by participants using telemonitoring and identified points for improvement for future interventions.

    “However, the information gathered was able to provide a good overview of the difficulties encountered by the participants that used telemonitoring, as well as identifying points for improvement to be considered for future telemonitoring interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Patient satisfaction was assessed in nine studies, with five concluding that patient satisfaction was improved by telemonitoring.

    “Patient satisfaction was also assessed in nine studies, with five concluding that patient satisfaction was improved by telemonitoring.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Leo DG, Buckley BJ, Chowdhury M, Harrison SL, Isanejad M, Lip GY, Wright DJ, Lane DA. Interactive remote patient Monitoring Devices for managing Chronic Health Conditions: systematic review and Meta-analysis. J Med Internet Res. 2022;24(11):e35508. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The low number of studies and the wide variety of interventions may have impacted the results of this meta-synthesis, as patients' perception of telemonitoring may have been affected.

    “The low number of studies and the wide variety of interventions presented (which ranged from telephone monitoring to mobile apps), may have impacted the results of this meta-synthesis, as patients’ perception of telemonitoring (such as “easiness of use” of the devices) may have been affected.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    No grey literature search was conducted, which may have led to some relevant studies being omitted.

    “No grey literature search was conducted, which may have led to some relevant studies being omitted.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Studies reporting the use of different devices were included, as well as perspectives from both HCPs and patients, providing more expansive results.

    “Studies reporting the use of different devices were also included as well as perspectives from both HCPs and patients, providing more expansive results.”
    Quote in the paperSubstantial claim
78 of 78

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Study [24] is assigned the wrong sample size

    Minor

    The discussion describes study [24] as having a sample size of ten, but Table 1 lists 48 participants for that study. Table 1 instead lists ten participants for study [25].

  • Grounded-theory analysis is attributed to the wrong study

    Minor

    The characteristics text attributes grounded-theory analysis to study [23], whereas Table 1 assigns it to Beran [21] and lists thematic analysis for Hanley [23].

  • A study outside the included set is counted among the findings

    Minor

    The paper says the nine included studies are references [19-27], but its account of their self-care findings counts reference [12] as one of three studies.

  • Patient sex percentages do not fit the reported patient count

    Minor

    The Buis row reports 13 patients, but its patient percentages of 53.3% male and 46.7% female cannot result from whole-person counts out of 13. Those percentages instead correspond to counts out of all 15 participants.

  • Technology theme omits a study discussed under that theme

    Minor

    The introduction to Theme 3 says it arose in six cited studies, but its convenience-and-acceptability section also discusses findings from study [26]. That makes at least seven studies represented in the theme.

5 of 5

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. DH/Long Term Conditions. Long Term Conditions Compendium of Information: Third Edition. In. Edited by Care DoHaS, Third edn. Department of Health: Department of Health; 2012.

Cited by

Sorted by citations

Authors
Creber, A., Leo, D. G., Buckley, B. J. R., Chowdhury, M., Harrison, S. L., Isanejad, M., Lane, D. A., & on behalf of the TAILOR investigators
Affiliations
University of Liverpool (GB)
Corresponding author
Leo, Donato Giuseppe
ORCID
Venue
BMC Cardiovascular Disorders
Publisher
Springer Science and Business Media LLC
Published
2023-09-19
Volume
23
Issue
1
Pages
469-469
ISSN
1471-2261 (ISSN-L)
DOI
10.1186/s12872-023-03486-3
PMC
PMC10510185
OpenAlex
W4386858159
Semantic Scholar
6f92c2f8fa4d0ef175b0b5c5e45decf9630b91c9
Cited by
50
References
24
Citations by year
2026: 22 · 2025: 18 · 2024: 8 · 2023: 2
FWCI
12.75
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cardiovascular Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (acceptedVersion, cc-by)
  • Liverpool John Moores University (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Liverpool Clinical Commissioning Group, Research Capability Funding (LCCG_RCF20-21_01)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Demography › Technology Use by Older Adults
Keywords
remote patient monitoring, patient self-management, chronic disease, barriers and facilitators, technology acceptability, patient perspectives, caregiver perspectives, healthcare professional perspectives, type 2 diabetes, chronic obstructive pulmonary disease, cardiovascular disease, generational differences, patient adherence
MeSH terms
Self-Management, Cardiovascular Diseases, Chronic Disease, Diabetes Mellitus, Type 2, Humans, Pulmonary Disease, Chronic Obstructive

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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