The effect of telehealth on clinical outcomes in patients with hypertension and diabetes: A meta-analysis of 106,261 patients.

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Francinny Alves Kelly, Francisco Cezar Aquino de Moraes, Artur de Oliveira Macena Lôbo, Vitor Kendi Tsuchiya Sano, Maria Eduarda Cavalcanti Souza, Artur Menegaz de Almeida, Michele Kreuz, Antônio Gabriele Laurinavicius, Fernanda Marciano Consolim-Colombo
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Abstract

Introduction: Telemedicine, propelled by recent technological advancements, has transformed healthcare delivery, notably benefiting patients with chronic non-communicable diseases (NCDs) such as systemic arterial hypertension and diabetes mellitus. This meta-analysis of randomized clinical trials aimed to assess the efficacy of telehealth-based interventions on disease control rates and clinical parameters among NCD patients, including systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) levels.

Methods: We conducted searches in PubMed, Scopus, Web of Science, and the Cochrane Database for interventional studies that compared tele-monitoring with usual care in patients with hypertension and type 2 diabetes mellitus. Odds ratios with 95% confidence intervals (CIs) were computed.

Results: Our meta-analysis included 75 studies, encompassing a total of 106,261 patients, with 50,074 (47.12%) receiving usual care and 56,187 (52.88%) receiving tele-monitoring care. The telemedicine group was associated with a statistically significant reduction in SBP (mean difference (MD) -4.927 mmHg; 95% CI -6.193 to -3.660; p < 0.001; I² = 90%), DBP (MD -2.019 mmHg; 95% CI -2.679 to -1.359; p < 0.001; I² = 54%), FBG (MD -0.405 mmol/L; 95% CI -0.597 to -0.213; p < 0.001; I² = 32%), and HbA1c (MD -0.418%; 95% CI -0.525 to -0.312; p < 0.001; I² = 76%).

Conclusions: Our meta-analysis shows that telehealth technologies notably enhance blood pressure and blood glucose control. This supports integrating telemedicine into clinical protocols as a valuable complementary tool for managing hypertension and diabetes mellitus comprehensively.

远程医疗对高血压和糖尿病患者临床疗效的影响:对 106,261 名患者的荟萃分析。
导语:在最近技术进步的推动下,远程医疗改变了医疗保健服务,特别是使患有全身性动脉高血压和糖尿病等慢性非传染性疾病的患者受益。这项随机临床试验的meta分析旨在评估远程医疗干预对非传染性疾病患者疾病控制率和临床参数(包括收缩压和舒张压)、空腹血糖(FBG)和糖化血红蛋白(HbA1c)水平)的疗效。方法:我们在PubMed、Scopus、Web of Science和Cochrane数据库中检索了对高血压和2型糖尿病患者进行远程监护与常规监护比较的介入研究。计算95%置信区间(ci)的比值比。结果:我们的荟萃分析包括75项研究,共计106261例患者,其中50074例(47.12%)接受常规护理,56187例(52.88%)接受远程监护。远程医疗组与收缩压降低有统计学意义(平均差值(MD) -4.927 mmHg;95% CI -6.193 ~ -3.660;p I²= 90%),DBP (MD -2.019 mmHg;95% CI -2.679 ~ -1.359;p²= 54%),FBG (MD -0.405 mmol/L;95% CI -0.597 ~ -0.213;p²= 32%),HbA1c (MD -0.418%;95% CI -0.525 ~ -0.312;pi²= 76%)。结论:我们的荟萃分析显示,远程医疗技术显著提高血压和血糖控制。这支持将远程医疗纳入临床方案,作为全面管理高血压和糖尿病的宝贵补充工具。
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来源期刊
CiteScore
14.10
自引率
10.60%
发文量
174
审稿时长
6-12 weeks
期刊介绍: Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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