Cited by 499Telemedicine and Telehealth ImplementationMobile Health and mHealth ApplicationsDiabetes Management and Education

The DOI matches its Crossref record; 76 of the 78 references it cites were found in a registry or an index, and 2 are not checked yet; none of the 288 sources its claims cite is checked for support yet.

Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer

Open access

Hanlon, Peter, Daines, Luke, Campbell, Christine, McKinstry, Brian, Weller, David, Pinnock, Hilary·2017·Journal of Medical Internet Research

DOI 10.2196/jmir.6688PMC PMC5451641

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Abstract

BACKGROUND: Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. OBJECTIVE: The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support. METHODS: We performed a metareview (a systematic review of systematic reviews) of randomized controlled trials (RCTs) of telehealth interventions to support self-management in 6 exemplar long-term conditions. We searched 7 databases for reviews published from January 2000 to May 2016 and screened identified studies against eligibility criteria. We weighted reviews by quality (revised A Measurement Tool to Assess Systematic Reviews), size, and relevance. We then combined our results in a narrative synthesis and using harvest plots. RESULTS: We included 53 systematic reviews, comprising 232 unique RCTs. Reviews concerned diabetes (type 1: n=6; type 2, n=11; mixed, n=19), heart failure (n=9), asthma (n=8), COPD (n=8), and cancer (n=3). Findings varied between and within disease areas. The highest-weighted reviews showed that blood glucose telemonitoring with feedback and some educational and lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes, and that telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, but these findings were not consistent in all reviews. Results for the other conditions were mixed, although no reviews showed evidence of harm. Analysis of the mediating role of self-management, and of components of successful interventions, was limited and inconclusive. More intensive and multifaceted interventions were associated with greater improvements in diabetes, heart failure, and asthma. CONCLUSIONS: While telehealth-mediated self-management was not consistently superior to usual care, none of the reviews reported any negative effects, suggesting that telehealth is a safe option for delivery of self-management support, particularly in conditions such as heart failure and type 2 diabetes, where the evidence base is more developed. Larger-scale trials of telehealth-supported self-management, based on explicit self-management theory, are needed before the extent to which telehealth technologies may be harnessed to support self-management can be established.

Checked 2026-10-06 · 2 references not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This metareview synthesized 53 systematic reviews (231 unique RCTs per Results; abstract says 232) of telehealth interventions to support self-management in diabetes, heart failure, asthma, COPD, and cancer. Evidence was inconsistent and no single self-management component was consistently effective, but no reviews reported harm, with the strongest support in type 2 diabetes and heart failure.

Key findings

Included 53 systematic reviews comprising 231 unique RCTs (119 diabetes, 58 heart failure, 28 asthma, 23 COPD, 3 cancer); the abstract reports 232 unique RCTs. Findings varied between and within disease areas.
Highest-weighted reviews showed blood glucose telemonitoring with feedback and some educational/lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes; telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, though findings were not consistent in all reviews.
No reviews showed evidence of harm; results for asthma, COPD, and cancer were mixed, and more intensive/multifaceted interventions were associated with greater improvements in diabetes, heart failure, and asthma.
Analysis of the mediating role of self-management and of components of successful interventions was limited and inconclusive; no single self-management component was consistently effective or ineffective.

Methods

Metareview (systematic review of systematic reviews) of RCTs of telehealth interventions to support self-management in 6 long-term conditions; searched 7 databases for reviews published January 2000 to May 2016.
Included 53 reviews; quality assessed with R-AMSTAR (scores 19–43 out of 44) and weighted by quality, size, and explicit self-management focus (8 reviews 3 stars, 23 reviews 2 stars, 21 reviews 1 star, 1 review no stars).
Because RCT overlap precluded meta-analysis, findings were combined in narrative synthesis and harvest plots; data were extracted from reviews, not individual RCTs, covering disease control, health care utilization, self-management process, and quality-of-life outcomes.

Limitations

Stated: metareview lag risks outdated results; reliance on review authors’ interpretation; inability to adjust for geography, age, or socioeconomic variables; RCT overlap risks overrepresenting some trials; only 6 conditions were considered; inclusion of reviews with implied self-management focus was potentially subjective; few reviews assessed publication bias.
Stated: most reviews did not analyze intervention intensity or specific components, limiting conclusions about which components or combinations are most beneficial.
Evident from the text: the abstract and Results report different unique RCT counts (232 vs 231); heterogeneity and poor intervention reporting limit component analysis; harvest plot rules may overlook individual RCTs.

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

Integrity signals

Registry

Crossref · 10.2196/jmir.6688

Cites

76 of 78 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 288 cited sources checked · 0 supported · 0 flagged

In the paper
“A total of 53 systematic reviews met the inclusion criteria [16,19-70].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Search Results
What the sources say
- Not checked yetcites [16,19-70]
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“Viana et al meta-analyzed adherence support interventions using various technologies and also found no improvement in HbA1c [49].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [49] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“In total, 19 reviews included both type 1 and 2 diabetes in their analyses, or included RCTs that did not differentiate [16,22,25,27,28,31,32,34-40,44,45,47,50,51].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [16] source
- Not checked yetcites [22] source
- Not checked yetcites [25] source
- Not checked yetcites [27] source
- Not checked yetcites [28] source
- Not checked yetcites [31] source
- Not checked yetcites [32] source
- Not checked yetcites [34] source
- Not checked yetcites [35] Krishna, S, 2008, J Diabetes Sci Technol source
- Not checked yetcites [36] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Wu et al meta-analyzed 7 RCTs of telephone follow-up and found no significant improvement in HbA1c compared with usual care in the overall pooled analysis [53].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [53] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“However, a prespecified subgroup analysis of more intensive targeted interventions (n=3 RCTs) showed a statistically significant benefit on glycemic control.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [53] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedn = 3
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Beatty et al reviewed Web-based lifestyle interventions and found no impact on glycemic control [21].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Two 1-star reviews (1 of mobile telemonitoring and 1 of Web-based telemonitoring) showed improved HbA1c compared with control [19,43].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [19] Baron, J, 2012, J Diabetes Sci Technol source
- Not checked yetcites [43] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Greenwood et al analyzed the components of remotely monitored blood glucose and found that multifaceted interventions carried greater benefit (discussed under self-management components) [30].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [30] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 10 reviews [21,29,30,33,42,43,46,52-54], and 1 analysis in a mixed review [19], analyzed HbA1c in type 2 diabetes.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
- Not checked yetcites [29] source
- Not checked yetcites [30] source
- Not checked yetcites [33] source
- Not checked yetcites [42] 2009, Ont Health Technol Assess Ser
- Not checked yetcites [43] source
- Not checked yetcites [46] source
- Not checked yetcites [52] source
- Not checked yetcites [53] source
- Not checked yetcites [54] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“A meta-analysis scoring no stars in the weighting system also showed no improvement in glycemic control [41].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [41] Montori, VM, 2004, Diabetes Care source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Narrative syntheses showed mixed results, with modest benefit in telehealth interventions both in place of and supplementing usual care [37], little evidence of benefit from telehealth interventions that excluded telephone support [28], and positive results for telehealth-delivered behavioral interventions (n=13 RCTs) [22].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [37] source
Load-bearingStrength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“Narrative syntheses showed mixed results, with modest benefit in telehealth interventions both in place of and supplementing usual care [37], little evidence of benefit from telehealth interventions that excluded telephone support [28], and positive results for telehealth-delivered behavioral interventions (n=13 RCTs) [22].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [28] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Liang et al evaluated mobile phone interventions targeting glycemic control and found a significant improvement over usual care in a meta-analysis of 11 RCTs.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [38] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [22] source
- Not checked yetcites [27] source
- Not checked yetcites [28] source
- Not checked yetcites [31] source
- Not checked yetcites [37] source
- Not checked yetcites [40] source
- Not checked yetcites [44] source
- Not checked yetcites [50] Verhoeven, F, 2010, J Diabetes Sci Technol source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Small et al reviewed telephone-only interventions incorporating “lay health workers” and showed a small but significant improvement in HbA1c over usual care [45].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [45] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“A meta-analysis of teleconsultations showed no benefit in terms of HbA1c [50].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [50] Verhoeven, F, 2010, J Diabetes Sci Technol source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Narrative syntheses showed mixed results, with modest benefit in telehealth interventions both in place of and supplementing usual care [37], little evidence of benefit from telehealth interventions that excluded telephone support [28], and positive results for telehealth-delivered behavioral interventions (n=13 RCTs) [22].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [22] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedn = 13
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“This effect was more marked for type 2 than for type 1 diabetes [38].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [38] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Three 1-star narrative syntheses suggested improved outcomes with mobile phone interventions [32,35,36], but others showed no overall benefit from teleconsultations [47,51] or telemonitoring [34,39].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [32] source
- Not checked yetcites [35] Krishna, S, 2008, J Diabetes Sci Technol source
- Not checked yetcites [36] source
Strength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 9 reviews analyzed telehealth interventions for heart failure [16,20,28,55-60].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [16] source
- Not checked yetcites [20] source
- Not checked yetcites [28] source
- Not checked yetcites [55] source
- Not checked yetcites [56] source
- Not checked yetcites [57] source
- Not checked yetcites [58] source
- Not checked yetcites [59] source
- Not checked yetcites [60] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Three 1-star narrative syntheses suggested improved outcomes with mobile phone interventions [32,35,36], but others showed no overall benefit from teleconsultations [47,51] or telemonitoring [34,39].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [47] source
- Not checked yetcites [51] source
- Not checked yetcites [34] source
- Not checked yetcites [39] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“The highest-weighted meta-analysis was Inglis et al [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [58] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“The use of telehealth, without telephone support, showed no impact on health care utilization in a 2-star weighted narrative synthesis of 6 RCTs [28].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [28] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“This review separately analyzed structured telephone support and telemonitoring of physiological parameters.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [58] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“A sensitivity analysis of the telephone-based interventions showed no difference between symptom monitoring and education-focused telephone calls.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [58] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 8 reviews assessed the impact on asthma control through symptom scores, quality of life, or unscheduled health care [20,24,27,28,36,61-63].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [20] source
- Not checked yetcites [24] source
- Not checked yetcites [27] source
- Not checked yetcites [28] source
- Not checked yetcites [36] source
- Not checked yetcites [61] Jaana, M, 2009, Am J Manag Care
- Not checked yetcites [62] source
- Not checked yetcites [63] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“One showed no evidence of improved quality of life or emotional or physical wellbeing in an RCT of moderated Internet-based self-help for breast cancer patients [21].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Three 1-star reviews, all with narrative syntheses, concluded that further evaluation was needed before conclusions could be reached [28,36,61], while 1 other, focused on mobile interventions in developing countries, found evidence for improved symptom scores in a single RCT [20].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [28] source
- Not checked yetcites [36] source
- Not checked yetcites [61] Jaana, M, 2009, Am J Manag Care
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Of the 3 reviews that included cancer RCTs, 2 contained analyses of physical outcomes [21,70].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
- Not checked yetcites [70] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Three 1-star reviews, all with narrative syntheses, concluded that further evaluation was needed before conclusions could be reached [28,36,61], while 1 other, focused on mobile interventions in developing countries, found evidence for improved symptom scores in a single RCT [20].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [20] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Both reviews were 2-star weighted.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
- Not checked yetcites [70] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Of the 8 COPD reviews, 7 analyzed the impact on disease control [27,64-69].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [64] source
- Not checked yetcites [65] source
- Not checked yetcites [66] Franek, J, 2012, Ont Health Technol Assess Ser
- Not checked yetcites [67] source
- Not checked yetcites [68] source
- Not checked yetcites [69] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Four 1-star weighted narrative syntheses emphasized either a lack [27,64,65] or a low quality [66] of evidence for improved health outcomes.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [64] source
- Not checked yetcites [65] source
- Not checked yetcites [66] Franek, J, 2012, Ont Health Technol Assess Ser
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“McLean et al found significantly fewer emergency department visits and hospital admissions than with usual care.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [68] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Findings for quality of life assessed by St George’s Respiratory Questionnaire were inconsistent [68].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [68] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“they did identify a significant improvement in a prespecified subgroup analysis of interventions providing intensive professional support [53].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [53] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“In asthma and COPD, the findings were typically neutral [27,67].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [67] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“The highest-quality evidence for heart failure showed an overall improvement in mortality in meta-analyses of telemonitoring and telephone support [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [58] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“those including 5 or more were associated with significant improvement in HbA1c.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [30] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“This was the most commonly described telehealth component in the included systematic reviews and was associated with improved clinical outcomes in diabetes and heart failure [33,35,36,38,42,44,54,58]; however, findings for asthma and COPD were mostly neutral or inconsistent [61-63,65,66,68,69].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [61] Jaana, M, 2009, Am J Manag Care
- Not checked yetcites [62] source
- Not checked yetcites [63] source
- Not checked yetcites [65] source
- Not checked yetcites [66] Franek, J, 2012, Ont Health Technol Assess Ser
- Not checked yetcites [68] source
- Not checked yetcites [69] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“This was the most commonly described telehealth component in the included systematic reviews and was associated with improved clinical outcomes in diabetes and heart failure [33,35,36,38,42,44,54,58]; however, findings for asthma and COPD were mostly neutral or inconsistent [61-63,65,66,68,69].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [33] source
- Not checked yetcites [35] Krishna, S, 2008, J Diabetes Sci Technol source
- Not checked yetcites [36] source
- Not checked yetcites [38] source
- Not checked yetcites [42] 2009, Ont Health Technol Assess Ser
- Not checked yetcites [44] source
- Not checked yetcites [54] source
- Not checked yetcites [58] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“The only review to address explicitly the question of which components were associated with improved disease outcomes was Greenwood et al, weighted 2 stars [30].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [30] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“In contrast, none of the reviews assessing mortality in COPD showed any significant improvement with telehealth [65,66,68,69].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [65] source
- Not checked yetcites [66] Franek, J, 2012, Ont Health Technol Assess Ser
- Not checked yetcites [68] source
- Not checked yetcites [69] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“A 3-star weighted review by Farmer et al analyzed the impact on medication adherence of interventions using remote monitoring, messaging, or a combination [26]. Meta-analysis of 8 interventions showed a nonsignificant effect size”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [26] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“No interventions were found incorporating all 7 components”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [30] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“The impact of this on glycemic control or other outcomes was not reported.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [26] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“only 6 of the 15 interventions reported some improvement in medication adherence.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [26] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“By contrast, Inglis et al showed no significant impact on mortality of an exploratory subgroup analysis based on intensity of telemonitoring in heart failure [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [58] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Wu et al, who analyzed telephone interventions for type 2 diabetes, found no overall improvement in HbA1c in a meta-analysis”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [53] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“no reviews specifically addressed how potential participants were identified, recruited, and retained, a key issue if telehealth interventions are to be successfully implemented [73].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Strengths and Limitations
What the sources say
- Not checked yetcites [73] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“There was some evidence for reduced hospitalization with telehealth interventions in more severe asthma and COPD [63,68]”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [63] source
- Not checked yetcites [68] source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“In heart failure, evidence linking knowledge, self-efficacy, or self-care behaviors to improvements in disease outcomes was either lacking or inconsistent [56].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [56] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“While components of the reported interventions mapped to Pearce et al’s taxonomy of self-management support [14], few reviews analyzed how these related to the self-management process or clinical outcomes.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [14] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“In common with other overarching analyses of self-management support [12], we found no evidence to support 1 component as being consistently effective or essential for improved outcomes.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“analyses of more specific, self-management-focused interventions showed insufficient or inconsistent evidence of benefit [27,62].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [62] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“Interventions for type 1 diabetes did not improve glycemic control [49].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [49] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“and it is not clear whether this applies to other disease areas [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Conclusions
What the sources say
- Not checked yetcites [58] source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“The review found that no single component of self-management interventions could be identified as being more important than others, but also that the detail and quality of reporting of these complex interventions was a barrier to their wider implementation and the understanding of their effective components [12,13].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
- Not checked yetcites [13] Hoffmann, TC, 2013, BMJ source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“While some evidence suggests that, in the context of type 2 diabetes, more intensive interventions may be associated with greater improvements in glycemic control, such observations are limited to specific analyses from a small number of included reviews [22,30,53]”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Conclusions
What the sources say
- Not checked yetcites [22] source
- Not checked yetcites [30] source
- Not checked yetcites [53] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“However, qualitative explorations of some asthma and COPD interventions suggested that daily professional monitoring of telemonitored parameters (such as pulse oximetry or symptom scores) could engender reliance on professionals rather than supporting self-management [11,76,78,79].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [11] source
- Not checked yetcites [76] source
- Not checked yetcites [78] source
- Not checked yetcites [79] source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Some felt empowered by these interventions to use the health care system more effectively [76,77].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [76] source
- Not checked yetcites [77] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“In contrast, self-monitoring (including oximetry) without daily professional oversight gave patients greater confidence in following their self-management plans [80].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [80] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes

It may state two separate claims as one. 78
Probably not a substantial claim. 50

None of the sources cited for this claim have been checked yet.
In the paper
“Taking into account quality assessment, explicit self-management focus, and total population size, 8 reviews received an evidence weighting of 3 stars [16,21,25,26,38,45,53,56], 23 received 2 stars [22,24,27-31, 33,37,40,42,44,46,49,50,52,54,55,58,62,63,67,68], 21 received 1 star [19,20,23,32,34-36,39,43,47,48,51,57, 59-61,64-66,69,70], and 1 received no stars [41].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Quality and Weighting of Included Reviews
What the sources say
- Not checked yetcites [16] source
- Not checked yetcites [21] source
- Not checked yetcites [25] source
- Not checked yetcites [26] source
- Not checked yetcites [38] source
- Not checked yetcites [45] source
- Not checked yetcites [53] source
- Not checked yetcites [56] source
- Not checked yetcites [22] source
- Not checked yetcites [24] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 5 reviews focused on type 1 diabetes [23,24,41,48,49] and 1 analyzed type 1 diabetes within a mixed review [19].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [23] source
- Not checked yetcites [24] source
- Not checked yetcites [41] Montori, VM, 2004, Diabetes Care source
- Not checked yetcites [48] source
- Not checked yetcites [49] source
- Not checked yetcites [19] Baron, J, 2012, J Diabetes Sci Technol source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Three 1-star narrative syntheses showed improvement in HbA1c limited to only a few RCTs, and all concluded that further evaluation was required [19,23,48].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [19] Baron, J, 2012, J Diabetes Sci Technol source
- Not checked yetcites [23] source
- Not checked yetcites [48] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Narrative syntheses found that telehealth-delivered educational interventions [52] and telephone interventions [29] did not improve glycemic control.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [52] source
- Not checked yetcites [29] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of these, 2 were awarded a 3-star weighting [21,53].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [21] source
- Not checked yetcites [53] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The former focused on mobile messaging interventions, including medication reminders, and found no improvement in hemoglobin A1c (HbA1c) compared with usual care in a meta-analysis of 2 RCTs [24].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [24] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Interventions included telemonitoring of blood glucose [33,42,54] and mobile messaging [46].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [33] source
- Not checked yetcites [42] 2009, Ont Health Technol Assess Ser
- Not checked yetcites [54] source
- Not checked yetcites [46] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The reviews of de Jongh et al [24] and Viana et al [49] were both weighted 2 stars.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [24] source
- Not checked yetcites [49] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of seven 2-star reviews [29,30,33,42,46,52,54], 4 were meta-analyses, all of which showed significant reductions in HbA1c compared with controls, although the effect sizes were small.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [29] source
- Not checked yetcites [30] source
- Not checked yetcites [33] source
- Not checked yetcites [42] 2009, Ont Health Technol Assess Ser
- Not checked yetcites [46] source
- Not checked yetcites [52] source
- Not checked yetcites [54] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Farmer et al assessed telemonitoring of self-monitored blood glucose and found no significant improvement in HbA1c in a meta-analysis of 9 RCTs, and either no difference or an increase in health care utilization in 6 RCTs [25].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [25] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of these, 4 were awarded a 3-star weighting [16,25,38,45], of which Farmer et al [25] , Small et al [45], and Liang et al [38] analyzed control or health care utilization outcomes, or both.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [16] source
- Not checked yetcites [25] source
- Not checked yetcites [38] source
- Not checked yetcites [45] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Interventions included telemonitoring of blood sugar [40,44] and interactive telehealth excluding telephone support [27].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [40] source
- Not checked yetcites [44] source
- Not checked yetcites [27] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 8 reviews were weighted 2 stars [22,27,28,31,37,40,44,50]; 4 of these included meta-analyses of impact on HbA1c, with 3 showing significant improvements over controls.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [22] source
- Not checked yetcites [27] source
- Not checked yetcites [28] source
- Not checked yetcites [31] source
- Not checked yetcites [37] source
- Not checked yetcites [40] source
- Not checked yetcites [44] source
- Not checked yetcites [50] Verhoeven, F, 2010, J Diabetes Sci Technol source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“In contrast, a 2-star narrative review showed no mortality benefit from telephone-only interventions and a variable effect on hospital admissions [55].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [55] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Some studies reported improvements in symptom scores; however, most showed no benefit.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [63] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The highest weighted of these (Ciere et al, 3 stars) did not include any disease control outcomes [56], nor did 3 others [16,59,60].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [56] source
- Not checked yetcites [16] source
- Not checked yetcites [59] source
- Not checked yetcites [60] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Self-management support was explicitly hypothesized as a mechanism by which these interventions might exert their effect, and both interventions reduced all-cause mortality.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [58] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Heart failure hospitalizations, but not all-cause hospital admissions, were also significantly lower with either telemonitoring or telephone support.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [58] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Both highlighted the potential benefit from some positive findings in the studies but acknowledged that these findings were not consistent and that the evidence base required development.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [24] source
- Not checked yetcites [62] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The highest weighted of these each scored 2 stars [24,27,62,63], including 3 narrative syntheses and 1 meta-analysis.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [24] source
- Not checked yetcites [27] source
- Not checked yetcites [62] source
- Not checked yetcites [63] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“McLean et al analyzed a wide range of telehealth interventions, including structured telephone support, education support, telemonitoring, and action plan components [63].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [63] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A 1-star weighted meta-analysis of telemonitoring for heart failure (excluding telephone interventions) showed a significant reduction in mortality and heart failure admissions, but not all-cause admissions or emergency department visits [57].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [57] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“de Jongh et al [24] and Marcano Belisario et al [62] reviewed mobile interventions and smartphone apps, respectively. The number of included RCTs was small for both (1 and 2, respectively).”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [24] source
- Not checked yetcites [62] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Meta-analyses showed no significant improvement in emergency department use or hospitalization at 3 months, but a significant reduction in hospitalizations compared with usual care at 12 months.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [63] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c [27,30,35-37,40,44-46].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [30] source
- Not checked yetcites [35] Krishna, S, 2008, J Diabetes Sci Technol source
- Not checked yetcites [36] source
- Not checked yetcites [37] source
- Not checked yetcites [40] source
- Not checked yetcites [44] source
- Not checked yetcites [45] source
- Not checked yetcites [46] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Lundell et al showed a significant improvement in physical activity with telehealth, but no impact on dyspnea [67].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [67] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Both 2-star meta-analyses concerned home-based telehealth using a variety of technologies, incorporating information transmission with personalized feedback.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [67] source
- Not checked yetcites [68] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“The highest weighted of the heart failure reviews (Ciere et al) specifically analyzed whether the beneficial effects of telehealth interventions on clinical outcomes were mediated by increases in knowledge, self-care, or self-efficacy [56].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [56] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Another meta-analysis, weighted 1 star, showed no impact on mortality but evidence of fewer hospitalizations in a narrative synthesis [69].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [69] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These included 2 meta-analyses, both weighted 2 stars [67,68].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [67] source
- Not checked yetcites [68] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“A 2-star weighted review of multiple conditions included a narrative synthesis of 5 RCTs of interactive telehealth interventions, excluding telephone-only support, and concluded no overall evidence of benefit in asthma [27].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [27] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“They found that evidence linking telehealth interventions with increased knowledge or self-care behaviors, or linking self-efficacy with self-care was “ambiguous,” and concluded that, on the basis of their findings and the poor methodological quality of the included studies, the evidence neither supports nor refutes their models [56].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [56] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“A total of 4 reviews (3 meta-analyses and 1 narrative syntheses) analyzed the impact of telehealth on all-cause mortality, and none showed a significant difference versus usual care [65,66,68,69,71,72].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [65] source
- Not checked yetcites [66] Franek, J, 2012, Ont Health Technol Assess Ser
- Not checked yetcites [68] source
- Not checked yetcites [69] source
- Not checked yetcites [71] Polisena, J, 2012, J Telemed Telecare source
- Not checked yetcites [72] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“The other review analyzed Internet-based education programs linking patients with clinicians and found no improvement in quality of life in 2 RCTs and an improvement in symptom scores in 1 of the RCTs [70].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [70] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Teleconsultations, videoconferencing, and telephone follow-up designed to review symptoms or clinical course were important aspects of telehealth interventions described by Inglis et al for heart failure, whose meta-analysis showed reduced mortality and heart failure hospital admission with telemonitoring and telephone review [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [58] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The highest-weighted evidence showed improvement in HbA1c in type 2 diabetes with interventions remotely monitoring blood glucose and in some more intensive telephone interventions [31,38,53].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [31] source
- Not checked yetcites [38] source
- Not checked yetcites [53] source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Cassimatis et al (2 stars) analyzed behavioral interventions (excluding telemonitoring) and found some improvements in self-care, dietary and medication adherence, and physical activity, but the effect was inconsistent [22].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [22] source
Strength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“They found that evidence linking telehealth interventions with increased knowledge or self-care behaviors, or linking self-efficacy with self-care was “ambiguous,” and concluded that, on the basis of their findings and the poor methodological quality of the included studies, the evidence neither supports nor refutes their models [56].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [56] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Several diabetes reviews included elements of remote clinical review, with some reporting positive outcomes [27,30,40].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [27] source
- Not checked yetcites [30] source
- Not checked yetcites [40] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Cassimatis et al highlighted in their analysis that more intensive lifestyle interventions appeared to have a greater impact on glycemic control [22].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [22] source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“few reviews specifically considered or assessed for publication bias and, of those that did, some found evidence to suggest bias [38,46].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [38] source
- Not checked yetcites [46] source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“They defined 7 separate components of telehealth (patient education, health care provider education, self-monitoring profile, blood glucose goals, use of blood glucose data to modify behavior, feedback to patients, and 2-way interaction).”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [30] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Physiological telemonitoring and telephone support for heart failure were associated with reduced mortality and heart failure-specific hospital admissions [58].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [58] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“For both of these conditions, however, findings were inconsistent between reviews, and analyses of similar interventions reached different conclusions [25,55,57].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [25] source
- Not checked yetcites [55] source
- Not checked yetcites [57] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“The rising prevalence of long-term conditions is a major clinical and public health challenge [1].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [1] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Telehealth has attracted considerable interest as a means of delivering care to those with long-term conditions [2].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [2] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Self-management—whereby individuals take on tasks to deal with medical management, role management, or emotional aspects of their condition [6]—is also increasingly recognized as important for effective management of long-term conditions [7-9].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [7] Department of HealthOur health, our care, our say: a new direction for community services20062016-09-21London, UKThe Stationary Officehttps://www.gov.uk/government/uploads/system/uploads/attachment_data/file/272238/6737.pdf
- Not checked yetcites [8] Department of HealthA new approach to chronic disease management for the 21st century20012016-09-21http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4018578.pdf
- Not checked yetcites [9] World Health OrganizationInnovative care for chronic conditions: building blocks for action20122016-09-21Geneva, SwitzerlandWHOhttp://www.who.int/chp/knowledge/publications/icccglobalreport.pdf
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“suggesting that telehealth is a safe option for delivery of self-management support, particularly in conditions such as heart failure and type 2 diabetes, where the evidence base is more developed.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Abstract > Conclusions
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: The included systematic reviews adequately assessed and reported harms or negative effects, so the absence of reported harm indicates that telehealth is safe.
In the paper
“A systematic overview of self-management interventions (Practical Reviews in Self-Management Support [PRISMS]) demonstrated that self-management support interventions across a range of 14 long-term conditions are complex and multifaceted, involve both the patient and health care professional, and need to be tailored to the individual and their specific condition and context [12].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
Load-bearingStrength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“A systematic overview of self-management interventions (Practical Reviews in Self-Management Support [PRISMS]) demonstrated that self-management support interventions across a range of 14 long-term conditions are complex and multifaceted, involve both the patient and health care professional, and need to be tailored to the individual and their specific condition and context [12].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
Load-bearingStrength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The review found that no single component of self-management interventions could be identified as being more important than others, but also that the detail and quality of reporting of these complex interventions was a barrier to their wider implementation and the understanding of their effective components [12,13].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
- Not checked yetcites [13] Hoffmann, TC, 2013, BMJ source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Telehealth has been proposed as one mechanism by which self-management may be promoted and enabled [10]”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [10] Steventon, A, 2012, BMJ source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The overlap in included RCTs (ie, reviews with similar inclusion criteria may include the same RCTs) precluded meta-analysis of the review findings; we therefore undertook a narrative synthesis.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Methods > Data Extraction and Interpretation
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: The included reviews' findings can be meaningfully combined in a narrative synthesis and harvest plots despite heterogeneity in outcomes and methods.
In the paper
“A systematic overview of self-management interventions (Practical Reviews in Self-Management Support [PRISMS]) demonstrated that self-management support interventions across a range of 14 long-term conditions are complex and multifaceted, involve both the patient and health care professional, and need to be tailored to the individual and their specific condition and context [12].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [12] Taylor, S, 2014, Southampton (UK); NIHR Journals Library
Strength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This taxonomy identified 14 separate components that might be adapted and used to support self-management across a range of long-term conditions.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Introduction
What the sources say
- Not checked yetcites [14] source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“The authors concluded that benefits were unlikely in mild asthma but that those at higher risk of hospitalization may benefit.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [63] source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“The authors emphasized that, despite some positive findings, the telehealth interventions were components in complex interventions and further evaluation would be required to clarify their role in COPD [68].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Impact of Telehealth Interventions on Disease Control and Health Care Utilization
What the sources say
- Not checked yetcites [68] source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“The authors concluded that a range of these components need to be incorporated into telehealth interventions for clinically significant improvements in diabetes self-management to be seen.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Results > Telehealth-Supported Components of Self-Management and Their Impact on Disease Control and the Process of Self-Management
What the sources say
- Not checked yetcites [30] source
Load-bearingStrength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“A recent metareview of heart failure telemonitoring interventions showed a reduction in all-cause mortality (relative risk 0.60-0.85) and heart failure hospitalizations (relative risk 0.64-0.86) in an analysis of 15 meta-analyses [74].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [74] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Greenwood et al concluded that a range of components (including educational, self-monitoring, goal-driven, and interactive elements) were important in improving glycemic control [30] and emphasized the multifaceted nature of self-management support.”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [30] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Interventions with multiple components, or more intensive interventions, may be associated with greater benefits [30,53,63,68].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Statement of Main Findings
What the sources say
- Not checked yetcites [30] source
- Not checked yetcites [53] source
- Not checked yetcites [63] source
- Not checked yetcites [68] source
Load-bearingStrength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“An overview of telehealth across a number of conditions noted modest improvements in HbA1c in some reviews with others noting no overall effect [2].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [2] source
Strength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“A strength of metareview methodology is that it allows a relatively rapid synthesis of a large body of primary literature and enables a broad overview of a subject area [15].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Strengths and Limitations
What the sources say
- Not checked yetcites [15] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Such questions have been addressed using qualitative methodologies [75], which have highlighted that users valued convenience [76], a sense of being “watched over” [11,77], and finding the telemonitoring data reassuring [78].”
§ Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer > Discussion > Comparison With Other Literature
What the sources say
- Not checked yetcites [75] Medical Research CouncilDeveloping and evaluating complex interventions: new guidance20062016-09-21Swindon, UKMRChttp://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/
- Not checked yetcites [76] source
- Not checked yetcites [11] source
- Not checked yetcites [77] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.

109 of 109

The paper relies on this without support.
The included systematic reviews adequately assessed and reported harms or negative effects, so the absence of reported harm indicates that telehealth is safe.
“none of the reviews reported any negative effects”
“no reviews showed evidence of harm”
The paper relies on this without support.
The extent to which telehealth effectively promotes self-management, and the components of telehealth interventions that contribute to this goal, remain unclear.
“The extent to which telehealth effectively promotes self-management, and the components of telehealth interventions that contribute to this goal, remain unclear.”
The paper relies on this without support.
The included reviews' findings can be meaningfully combined in a narrative synthesis and harvest plots despite heterogeneity in outcomes and methods.
“we therefore undertook a narrative synthesis”
“We used harvest plots to illustrate the disease control outcomes related to telehealth-supported self-management components [17,18].”
The paper relies on this without support.
The included systematic reviews collectively provide a sufficiently complete and unbiased evidence base for the metareview's conclusions about telehealth for self-management of the six conditions.
“By relying on systematic review findings, the evidence is 1 step removed from the empirical evidence, and thus reliant on the interpretation of the review authors.”
The paper relies on this without support.
The six selected long-term conditions are representative enough to generalize the metareview's conclusions about telehealth for self-management to long-term conditions more broadly.
“This metareview considered only 6 long-term conditions and may have reached different conclusions had we selected a different set of conditions.”

5 of 5

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.

COPD mortality review designs do not match their descriptions
Minor
The four included reviews cited for COPD mortality are 65, 66, 68, and 69. The text elsewhere identifies 65 and 66 as narrative syntheses and 68 and 69 as meta-analyses, contradicting the stated split of three meta-analyses and one narrative synthesis.
Conflicting counts of unique RCTs
Minor
The abstract reports 232 unique RCTs, while the Results reports 231. The disease-specific counts in the Results also sum to 231.
Cancer reviews' star weightings conflict with the weighting list
Minor
The cancer section says both reviews were weighted 2 stars, but the earlier weighting list assigns review 21 three stars and review 70 one star.

3 of 3

Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925
Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1978) · Advances in Behaviour Research and Therapy · doi:10.1016/0146-6402(78)90002-4 · Cited by 10,586
Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60240-2 · Cited by 6,972 · cited 1×
“The rising prevalence of long-term conditions is a major clinical and public health challenge [1].”
Methodology in conducting a systematic review of systematic reviews of healthcare interventions
Smith, V., Devane, D., Begley, C. M., & Clarke, M. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-15 · Cited by 1,227 · cited 2×
“A strength of metareview methodology is that it allows a relatively rapid synthesis of a large body of primary literature and enables a broad overview of a subject area [15].”
Effectiveness of telemedicine: A systematic review of reviews
Ekeland, A. G., Bowes, A., & Flottorp, S. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2010.08.006 · Cited by 1,162 · cited 1×
“Definitions of telehealth are many and varied [3], and the technologies involved are novel and evolving [4]: in this paper we use the term to refer to any use”
Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review
Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3951 · Cited by 1,149 · cited 5×
“A total of 53 systematic reviews met the inclusion criteria [16,19-70].”
Influential
Healthcare via Cell Phones: A Systematic Review
Krishna, S., Boren, S. A., & Balas, E. A. (2009) · Telemedicine and e-Health · doi:10.1089/tmj.2008.0099 · Cited by 882 · cited 8×
“Supported education and information interventions were particularly effective in the context of diabetes, with 9 larger systematic reviews showing evidence of improvement in HbA1c [27,30,35-37,40,44-46].”
Influential
Interactive telemedicine: effects on professional practice and health care outcomes
Flodgren, G., Rachas, A., Farmer, A. J., Inzitari, M., & Shepperd, S. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002098.pub2 · Cited by 806 · cited 10×
“A total of 53 systematic reviews met the inclusion criteria [16,19-70].”
Influential
Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies
O’Connor, S., Hanlon, P., O’Donnell, C. A., Garcia, S., Glanville, J., & Mair, F. S. (2016) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-016-0359-3 · Cited by 636
Self-citation
What Is Telemedicine? A Collection of 104 Peer-Reviewed Perspectives and Theoretical Underpinnings
Sood, S., Mbarika, V., Jugoo, S., Dookhy, R., Doarn, C. R., Prakash, N., & Merrell, R. C. (2007) · Telemedicine and e-Health · doi:10.1089/tmj.2006.0073 · Cited by 627 · cited 1×
“Definitions of telehealth are many and varied [3], and the technologies involved are novel and evolving [4]: in this paper we use the term to refer to any use”

Flagged first, then by citations

Show all 78 references

Research works printed but not linked: 5

Taylor, S, 2014, Southampton (UK); NIHR Journals Library, 1
2009, Ont Health Technol Assess Ser, 9, 1
Jaana, M, 2009, Am J Manag Care, 15, 313
Franek, J, 2012, Ont Health Technol Assess Ser, 12, 1
10.1016/j.pop.2012.03.005 · DOI

Sorted by citations

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“mHealth is emerging as a vital platform to perform self-management, especially for chronic diseases [11].”
Background
Videoconferencing psychotherapy and depression: a systematic review
Berryhill, M. B., Culmer, N., Williams, N., Halli-Tierney, A., Betancourt, A., Roberts, H., & King, M. (2019) · Telemedicine and e-Health · doi:10.1089/tmj.2018.0058 · Cited by 275
Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: An umbrella review of systematic reviews and meta-analyses
Timpel, P., Oswald, S., Schwarz, P. E. H., & Harst, L. (2020) · Journal of Medical Internet Research · doi:10.2196/16791 · Cited by 243
“Owing to the need for individualized and continuous monitoring and self-management support for patients, chronic diseases are considered the ideal target conditions for the development and implementation of telemedicine approaches [18,19].”
Background
Diversity of practices in telerehabilitation for children with disabilities and effective intervention characteristics: results from a systematic review
Camden, C., Pratte, G., Fallon, F., Couture, M. M., Berbari, J., & Tousignant, M. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2019.1595750 · Cited by 240
The Effectiveness of Smartphone Apps for Lifestyle Improvement in Noncommunicable Diseases: Systematic Review and Meta-Analyses
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“A recent systematic meta-review evaluated telehealth interventions, which are also regarded as mHealth, to support self-management of long-term conditions [36].”
Background

See all 499

Authors: Hanlon, P., Daines, L., Campbell, C., McKinstry, B., Weller, D., & Pinnock, H.
Affiliations: University of Edinburgh (GB)
Corresponding author: Pinnock, Hilary
ORCID: Hanlon, Peter
Daines, Luke
Campbell, Christine
McKinstry, Brian
Weller, David
Pinnock, Hilary
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2017-05-17
Volume: 19
Issue: 5
Pages: e172
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.6688
PMC: PMC5451641
OpenAlex: W2609520421
Semantic Scholar: 2aade83dc64d7ebc9bc9436027ed04c36c2fd2af
Cited by: 499
References: 78
Citations by year: 2026: 22 · 2025: 47 · 2024: 64 · 2023: 67 · 2022: 79 · 2021: 75 · 2020: 55 · 2019: 55 · 2018: 30 · 2017: 5
FWCI: 6.44
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research (RP-DG-1213-10008, 11/1014/04)
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
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: self-management support, chronic disease, diabetes mellitus, type 1 diabetes, type 2 diabetes, heart failure, asthma, chronic obstructive pulmonary disease, cancer, glycemic control, hospitalization, mortality, health care utilization, intervention components, telephone-delivered intervention, educational intervention, lifestyle intervention, mediating role
MeSH terms: Self-Management, Asthma, Chronic Disease, Delivery of Health Care, Diabetes Mellitus, Type 2, Heart Failure, Humans, Neoplasms, Telemedicine, Pulmonary Disease, Chronic Obstructive

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Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer

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