Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and meta-analysis.
Open accessAbstract
OBJECTIVE: To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard face-to-face interventions. DATA SOURCES: CINAHL, Embase, PsycINFO and PubMed databases were searched. The content of relevant journals and published articles were also searched. STUDY SELECTION: Studies examining the effectiveness of allied health and nursing telehealth interventions for rural and remote populations were included in descriptive analyses. Studies comparing telehealth intervention with standard face-to-face interventions grouped by type of intervention approach were used to examine between-groups effect sizes. DATA EXTRACTION: Methodological quality of studies was rated using the QualSyst critical appraisal tool and the National Health and Medical Research Council (NHMRC) Evidence Hierarchy levels. DATA SYNTHESIS: After quality ratings, 43 studies were included. A majority of studies had strong methodological quality. The disciplines of psychology and nursing were represented most frequently, as were studies using a cognitive intervention approach. Meta-analysis results slightly favoured telehealth interventions compared with face-to-face interventions, but did not show significant differences. Interventions using a combined physical and cognitive approach appeared to be more effective. CONCLUSION: Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.
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Remote monitoring, video and telephone consultations delivered by allied health professionals to patients in rural areas were at least as effective as face-to-face interventions.
“Remote monitoring, video and telephone consultations delivered by allied health professionals to patients in rural areas were at least as effective as face-to-face interventions [59].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [59]
The Discussion (page unavailable) reports that the meta-analysis found telehealth interventions were not less effective than face-to-face treatment in rural and remote areas. The Conclusion (page unavailable) qualifies this as 'may be as effective' and cautions that outcomes were heterogeneous. The copy does not establish that remote monitoring, video consultations, and telephone consultations each met that comparison, so the claim is more definite and modality-specific than the review supports. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe sole review that did not focus on a specialty described the effect of telemedicine interventions delivered by allied health professionals and nurses in rural and remote areas.
“The sole review that didn’t focus on a speciality described the effect of telemedicine interventions delivered by allied health professionals and nurses in rural and remote areas [8].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [8]
A nurse-led telecoaching study for rural patients was successful and cost-effective in T2DM management.
“A nurse-led telecoaching study for rural patients was successful and cost-effective in T2DM management [73-80].”
Telehealth offers patients the possibility of collecting and monitoring, in real-time, a set of data specific to their health or diseases without physical presence and direct intervention of health professionals.
“Studies have shown that telehealth offers patients the possibility of collecting and monitoring, in real-time, a set of data specific to their health or their diseases without the physical presence and direct intervention of health professionals [15,16].”
From Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic (2022) · cites this paper as [15]
For healthcare professionals, easier access to relevant information enables them to be better equipped during medical consultations and patient follow-up, supports decision-making, and improves exchanges and communication with patients.
“For healthcare professionals, easier access to relevant information enables them to be better equipped during medical consultations and patient follow-up, supports them in decision-making and improves the exchanges and communication with patients [14,15,16,17,18,19].”
From Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic (2022) · cites this paper as [15]
Telehealth platforms allow patients to communicate and interact virtually with their health professionals and obtain advice or information relevant to their health.
“Furthermore, telehealth platforms also allow patients to communicate and interact virtually with their health professionals and to obtain advice or information relevant to their health [14,15,16,17,18,19].”
From Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic (2022) · cites this paper as [15]
A patient who is well-informed about their disease, state of health, and treatments is better engaged in managing their health and benefits from a better quality of life.
“A patient who is well-informed about their disease, their state of health, and their treatments turns out to be better engaged in the management of their health and would benefit from a better quality of life [15,16].”
From Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic (2022) · cites this paper as [15]
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Jiang, H. Y., MacLean, A., Yoon, J., Hughes, S., Kim, M. J., Anantha, R. V., & Widder, S. L. (2020) · Canadian Journal of Surgery · doi:10.1503/cjs.007119 · Cited by 8 · see citing works
The use of information and communication technology in Japanese rural clinics
Teraura, H., Iguchi, S., Maeda, T., Koike, S., Matsumoto, M., Haruyama, S., & Kotani, K. (2021) · Journal of Rural Medicine · doi:10.2185/jrm.2021-026 · Cited by 8 · see citing works
- Authors
- Speyer, R., Denman, D., Wilkes-Gillan, S., Chen, Y., Bogaardt, H., Kim, J., Heckathorn, D., & Cordier, R.
- Affiliations
- Curtin University (AU)
- University of Oslo (NO)
- The University of Sydney (AU)
- Leiden University Medical Center (NL)
- Corresponding author
- Speyer, R
- Venue
- Journal of Rehabilitation Medicine
- Published
- 2018
- Volume
- 50
- Issue
- 3
- Pages
- 225-235
- ISSN
- 1650-1977 (ISSN-L)
- OpenAlex
- W2777885129
- Cited by
- 219
- References
- 79
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 24 · 2023: 39 · 2022: 36 · 2021: 34 · 2020: 40 · 2019: 13 · 2018: 2
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Rehabilitation Medicine (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline at James Cook University (James Cook University) (submittedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eSpace (Curtin University) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Demography › Technology Use by Older Adults
- Keywords
- telemedicine, allied health professionals, nurses, rural and remote health, face-to-face intervention, intervention effectiveness, cognitive intervention, health care access, rehabilitation
- MeSH terms
- Allied Health Personnel, Health Services Accessibility, Humans, Rural Population, Treatment Outcome, Telemedicine
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