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Cited by 137Telemedicine and Telehealth ImplementationMobile Health and mHealth ApplicationsTechnology Use by Older Adults

Assessing the implementability of telehealth interventions for self-management support: a realist review

Open access
Vassilev, Ivaylo, Rowsell, Alison, Pope, Catherine, Kennedy, Anne, O’Cathain, Alicia, Salisbury, Chris, Rogers, Anne·2015·Implementation Science
DOI 10.1186/s13012-015-0238-9PMC PMC4424965
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Abstract

BACKGROUND: There is a substantial and continually growing literature on the effectiveness and implementation of discrete telehealth interventions for health condition management. However, it is difficult to predict which technologies are likely to work and be used in practice. In this context, identifying the core mechanisms associated with successful telehealth implementation is relevant to consolidating the likely elements for ensuring a priori optimal design and deployment of telehealth interventions for supporting patients with long-term conditions (LTCs). METHODS: We adopted a two-stage realist synthesis approach to identify the core mechanisms underpinning telehealth interventions. In the second stage of the review, we tested inductively and refined our understanding of the mechanisms. We reviewed qualitative papers focused on COPD, heart failure, diabetes, and behaviours and complications associated with these conditions. The review included 15 papers published 2009 to 2014. RESULTS: Three concepts were identified, which suggested how telehealth worked to engage and support health-related work. Whether or not and how a telehealth intervention enables or limits the possibility for relationships with professionals and/or peers. Telehealth has the potential to reshape and extend existing relationships, acting as a partial substitute for the role of health professionals. The second concept is fit: successful telehealth interventions are those that can be well integrated into everyday life and health care routines and the need to be easy to use, compatible with patients' existing environment, skills, and capacity, and that do not significantly disrupt patients' lives and routines. The third concept is visibility: visualisation of symptoms and feedback has the capacity to improve knowledge, motivation, and a sense of empowerment; engage network members; and reinforce positive behaviour change, prompts for action and surveillance. CONCLUSIONS: Upfront consideration should be given to the mechanisms that are most likely to ensure the successful development and implementation of telehealth interventions. These include considerations about whether and how the telehealth intervention enables or limits the possibility for relationships with professionals and peers, how it fits with existing environment and capacities to self-manage, and visibility-enabling-enhanced awareness to self and others.

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  • This review found that spatial and temporal barriers, such as the need to travel to a hospital or clinic, were reduced or removed, and access to care for underserviced populations or areas was increased.

    “As reported by others [71,72], this review also found that spatial and temporal barriers, such as the need to travel to a hospital or clinic, were reduced or removed, and access to care for underserviced populations or areas was increased.”

    From Features of Structured, One-to-One Videoconference Interventions That Actively Engage People in the Management of Their Chronic Conditions: Scoping Review (2025) · cites this paper as [71]

    In Results and discussion, under “Fit with patient-defined needs and environment” (page not specified), the review describes at-home access at any time and the potential to improve care access for people in remote areas with poor transport. It qualifies that improvement as occurring when telehealth is successfully adapted to patients’ needs; the citing sentence presents reduced barriers and increased access as unqualified findings. (LLM, conf=0.82)

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  • The work by Vassilev et al found evidence that clients' capability in technology use increased their propensity to benefit from interventions.

    “The work by Vassilev et al [71] underscores this, finding “evidence that clients’ capability in technology use increased their propensity to benefit from interventions.””

    From Features of Structured, One-to-One Videoconference Interventions That Actively Engage People in the Management of Their Chronic Conditions: Scoping Review (2025) · cites this paper as [71]

  • The viewpoints of policy makers are seldom recorded in scientific publications despite their important role in the outer context of implementation.

    “The viewpoints of policy makers are seldom recorded in scientific publications despite their important role in the outer context of implementation [13-15].”

    From Perspectives of Policy Makers and Service Users Concerning the Implementation of eHealth in Sweden: Interview Study (2022) · cites this paper as [14]

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Authors
Vassilev, I., Rowsell, A., Pope, C., Kennedy, A., O’Cathain, A., Salisbury, C., & Rogers, A.
Affiliations
  • University of Southampton (GB)
  • University of Sheffield (GB)
Corresponding author
Vassilev, Ivaylo
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2015-04-24
Volume
10
Issue
1
Pages
59-59
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-015-0238-9
PMC
PMC4424965
OpenAlex
W2091049670
Cited by
137
References
45
Citations by year
2026: 2 · 2025: 6 · 2024: 13 · 2023: 8 · 2022: 16 · 2021: 15 · 2020: 11 · 2019: 15 · 2018: 20 · 2017: 13 · 2016: 14 · 2015: 3
FWCI
2.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
  • National Institute for Health and Care Research (NF-SI-0513-10103, RP-PG-0108-10011)
  • University of Southampton
  • European Commission (EU-FP7)
  • Programme Grants for Applied Research
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
telemedicine, self-management support, chronic disease, implementation mechanisms, patient-professional relationship, peer support, feedback, behavior change, chronic obstructive pulmonary disease, heart failure, diabetes mellitus, patient engagement
MeSH terms
Chronic Disease, Diabetes Mellitus, Heart Failure, Humans, Interpersonal Relations, Models, Theoretical, Professional-Patient Relations, Self Care, Health Behavior, Telemedicine, Needs Assessment, Pulmonary Disease, Chronic Obstructive, Evidence-Based Practice

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