Journal of Telemedicine and Telecare最新文献

{"title":"Impact of telepharmacy services on hospital emergency care utilisation: A systematic review and meta-analysis.","authors":"Anna L Barwick, Liam J Caffery, Anthony C Smith, Christopher Freeman","doi":"10.1177/1357633X261491464","DOIUrl":"https://doi.org/10.1177/1357633X261491464","url":null,"abstract":"<p><p>IntroductionTelepharmacy enables pharmacists to deliver clinical and medication-related services remotely, and its use has expanded rapidly in response to evolving patient needs and shifting models of care. While telepharmacy has demonstrated benefits across patient, provider, and system levels, its impact on hospital emergency care utilisation remains unclear, with studies report mixed findings.ObjectiveTo evaluate the impact of pharmacist-delivered telepharmacy interventions on utilisation of emergency department (ED) presentations and hospital readmissions.MethodsA systematic search for randomised controlled trials (RCTs) assessing the effectiveness of telepharmacy services was conducted in November 2025. The primary outcome was the effect of telepharmacy interventions on rates of hospital admission and/or ED presentation. A meta-analysis was completed for studies that reported 30-day hospital readmissions and ED presentations.ResultsSeventeen RCTs involving 9692 patients were included. Three studies reported a significant reduction in 30-day ED presentations, and three studies reported a significant reduction in 30-day hospital readmissions. Seven studies (<i>n = </i>1859 patients) were eligible for meta-analysis. Telepharmacy interventions were associated with a 6% absolute reduction in 30-day ED presentations (risk difference=0.06, 95% CI: 0.02-0.10, <i>p =</i>0.005). A non-significant reduction was observed in 30-day hospital readmission rates.ConclusionAcross a small number of heterogeneous RCTs, telepharmacy interventions were associated with a significant reduction in 30-day ED presentations but did not significantly reduce 30-day unplanned hospital readmissions. These findings highlight the potential value of telepharmacy in reducing emergency care utilisation.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261491464"},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Virtual-first lung cancer diagnostics: A promising signal that warrants cautious interpretation.","authors":"Yousaf Ali","doi":"10.1177/1357633X261485824","DOIUrl":"https://doi.org/10.1177/1357633X261485824","url":null,"abstract":"","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261485824"},"PeriodicalIF":3.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world provider-level costs of multidisciplinary telerehabilitation for neurological rehabilitation: A comparative cost analysis.","authors":"Pınar Güngör Ketenci, Özlem Öztekin, Mehmet Emin Karabulut, Başak Bilir Kaya, Kemal Memişoğlu","doi":"10.1177/1357633X261489681","DOIUrl":"https://doi.org/10.1177/1357633X261489681","url":null,"abstract":"&lt;p&gt;&lt;p&gt;IntroductionTelerehabilitation has emerged as a promising strategy for improving access to neurological rehabilitation while addressing increasing healthcare demands and resource constraints. Although evidence supporting its clinical effectiveness has expanded considerably, information regarding its economic implications and potential relevance for reimbursement policy and healthcare planning remains limited. This study aimed to compare the costs of a multidisciplinary telerehabilitation programme with those of conventional facility-based neurological rehabilitation and to estimate the potential budgetary consequences of large-scale implementation.MethodsA retrospective comparative cost analysis and budget impact assessment was conducted using prospectively collected programme data and hospital accounting records. The study included 243 individuals receiving telerehabilitation for stroke-related hemiplegia (&lt;i&gt;n&lt;/i&gt; = 90), Parkinson's disease (&lt;i&gt;n&lt;/i&gt; = 61), aphasia (&lt;i&gt;n&lt;/i&gt; = 60), and cerebral palsy (&lt;i&gt;n&lt;/i&gt; = 32). Conventional rehabilitation consisted of routine face-to-face multidisciplinary neurological rehabilitation delivered within the same healthcare system using comparable treatment intensity, and costs were derived from real-world institutional expenditure records. Costs were analysed from the health system/provider perspective and standardized to a 30-session rehabilitation episode. Cost outcomes included cost per session, cost per patient, absolute cost difference, relative cost reduction, and cost ratio. A simplified budget impact projection was performed to estimate projected expenditures and savings for hypothetical patient populations ranging from 1000 to 50,000 individuals.ResultsThe mean cost per rehabilitation session was United States Dollars (USD) 365.91 for conventional rehabilitation and USD 164.66 for telerehabilitation. The corresponding cost per patient for a standardized 30-session rehabilitation episode was USD 10,977.43 and USD 4939.84, respectively. Telerehabilitation reduced provider-level costs by USD 6037.59 per patient, corresponding to a relative cost reduction of 55.0%, meaning that telerehabilitation required only 45.0% of the provider cost of an equivalent episode of conventional rehabilitation. Budget impact projections demonstrated potential savings of approximately USD 6.0 million for 1000 patients, increasing to USD 301.9 million for 50,000 patients.ConclusionsIn this real-world provider-level economic analysis, multidisciplinary telerehabilitation was associated with substantially lower provider-level costs than conventional facility-based neurological rehabilitation. The observed cost reduction was primarily attributable to differences in infrastructure and operational resource utilization between service delivery models. If comparable clinical outcomes can be maintained, telerehabilitation may represent a financially sustainable strategy for expanding rehabilitation capacity while supporting e","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261489681"},"PeriodicalIF":3.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between MoodSensing smartphone application use and psychiatric readmissions and emergency department visits among patients with bipolar disorder in Taiwan.","authors":"Tim Jhao-Lin Tu, Jia-Yin Syu, Po See Chen, Ray Ruei-Yong Gao, Sheng-Hsiang Lin, Esther Ching-Lan Lin","doi":"10.1177/1357633X261489680","DOIUrl":"https://doi.org/10.1177/1357633X261489680","url":null,"abstract":"<p><p>IntroductionThis study examined the association between the frequency of MoodSensing smartphone application (MS app) use and psychiatric readmissions and emergency department visits among patients with bipolar disorder.MethodsA 6-month prospective observational pilot study was conducted among 183 patients with bipolar disorder recruited from the psychiatric outpatient department of a medical center in Taiwan. Participants were followed for 6 months and categorized into usage groups based on MS app usage frequency (unused, low-usage, and active users; ≥20% usage defined as active use). Outcomes included psychiatric readmissions and emergency department visits within 6 months, obtained from medical records. Associations between application use and outcomes were analyzed using Firth's logistic regression to account for rare events, adjusting for demographic characteristics and clinical covariates.ResultsParticipants had a mean age of 36.6 years, 57.4% were female, and the mean duration of bipolar disorder was 14.5 years. Overall, 157 participants (85.8%) used the MS app at least once during the 6-month follow-up. Compared with the unused group, active users had significantly lower adjusted odds of psychiatric readmissions (adjusted odds ratio = 0.13, 95% confidence interval = 0.02-0.87) and emergency department visits (adjusted odds ratio = 0.28, 95% confidence interval = 0.08-0.98).DiscussionActive MS app use was associated with lower odds of psychiatric readmissions and emergency department visits. Given the uncontrolled observational pilot design, these findings should be considered preliminary.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261489680"},"PeriodicalIF":3.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of telehealth versus in-person appointments for the treatment of obesity in a Brazilian public tertiary care center: A randomized controlled trial.","authors":"Flavio Roberto Silva Rocha, Raphaella Scorsi Ferreira, Carolina Castro Porto Silva Janovsky, Adriana Sañudo, Maria Teresa Zanella, Glaucia Carneiro","doi":"10.1177/1357633X261488474","DOIUrl":"https://doi.org/10.1177/1357633X261488474","url":null,"abstract":"<p><p>IntroductionAlthough telehealth interventions have produced weight-management outcomes comparable with in-person care in several settings, 12-month randomized evidence from public tertiary services in middle-income countries remains limited. This study compared remote and in-person consultations for obesity treatment in a Brazilian public tertiary-care center, focusing on continuity of care, weight loss, and exploratory metabolic outcomes.MethodsThis 12-month, matched-pair randomized, prospective, single-center, open-label pilot trial included 32 adults in a multidisciplinary weight-management program. Participants were allocated to telehealth video consultations or standard in-person care. The primary outcomes were appointment attendance and treatment adherence, defined a priori as the proportion of missed appointments that were rescheduled and subsequently attended. Secondary outcomes included percentage change in body weight, the proportion of participants achieving ≥5% weight loss, anthropometric measures, and metabolic parameters.ResultsThe overall absence rate did not differ significantly between the telehealth and in-person groups (12.5% vs. 17.1%; <i>p</i> = .413). All 10 missed telehealth appointments were rescheduled and attended, compared with 8 of 14 missed in-person appointments (100% vs. 57.1%; <i>p</i> = .024). Mean 12-month percentage weight change was -4.8% ± 4.7% in the telehealth group and -5.5% ± 3.8% in the in-person group, and 56.3% and 62.5% of participants, respectively, achieved ≥5% weight loss. Both groups had significant within-group reductions in waist and hip circumferences. HbA1c decreased within the telehealth group (6.39% ± 1.08% to 5.98% ± 0.46%; <i>p</i> = .005), but no between-group difference in HbA1c change was demonstrated.DiscussionIn this pilot trial, telehealth produced weight and anthropometric outcomes similar to those observed with in-person care and were associated with a higher proportion of missed appointments being rescheduled. The HbA1c finding was exploratory and does not establish metabolic superiority. Larger multicenter trials are needed to confirm these findings and assess long-term effectiveness, implementation, and cost-effectiveness.Trial registrationBrazilian Registry of Clinical Trials (ReBEC), RBR-7wt6hzm; UTN U1111-1318-5411. Registered on 7 April 2025, retrospectively.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261488474"},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, quality, and cost-effectiveness of telemedicine-based management of vitamin K antagonists in a public cardiology center.","authors":"Rafael Afonso Derencio Oliveira, Diego Marques Moroço, Altacílio Aparecido Nunes, Gustavo Jardim Volpe, Benedito Carlos Maciel, Antonio Pazin Filho, André Schmidt, Henrique Turin Moreira","doi":"10.1177/1357633X261479897","DOIUrl":"https://doi.org/10.1177/1357633X261479897","url":null,"abstract":"<p><p>BackgroundVitamin K antagonist (VKA) therapy requires frequent monitoring. Although telemedicine has expanded, evidence on its effectiveness in public health systems of developing countries remains limited. We evaluated the safety, quality of anticoagulation control, and cost-effectiveness of telemedicine-based versus in-person follow-up in a Brazilian tertiary public center.MethodsThis retrospective observational study at a Brazilian tertiary university hospital compared an in-person phase with the telemedicine phase initiated in April 2020. Outcomes were time in therapeutic range (TTR), all-cause and anticoagulation-related mortality, and direct healthcare costs. TTR was compared within patients (<i>n</i> = 661 followed regularly in both phases); mortality was compared as phase-specific annualized rates among all patients followed in each phase (1313 in-person; 1086 telemedicine).ResultsMedian TTR did not differ between the in-person and telemedicine phases (58% vs. 60%; <i>p</i> = .35). Annualized all-cause mortality (69 vs. 77 deaths per 1000 person-years; <i>p</i> = .43) and anticoagulation-related mortality (13 vs. 11 per 1000 person-years; <i>p</i> = .61) were also comparable. Cost-minimization analysis showed that telemedicine reduced annual direct expenditures by 10% (USD 4473; 95% CI: 2904-6030).DiscussionTelemedicine-based monitoring for patients on VKAs is as safe and clinically effective as traditional in-person care. Furthermore, telemedicine offers lower direct costs, proving to be a viable alternative to optimize resource allocation and enhance efficiency within the public health system.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261479897"},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keeping artificial intelligence-assisted telehealth useful and safe in routine care.","authors":"Reymond C Dalupang","doi":"10.1177/1357633X261479517","DOIUrl":"https://doi.org/10.1177/1357633X261479517","url":null,"abstract":"","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261479517"},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the application effect of new rehabilitation nursing methods in orthopedic postoperative rehabilitation: A systematic review and meta-analysis of randomized controlled trials.","authors":"Fan Cao, Lingyun Shi, Xiao Wang","doi":"10.1177/1357633X251408308","DOIUrl":"10.1177/1357633X251408308","url":null,"abstract":"<p><p>ObjectiveTo quantify the impact of technology-enabled rehabilitation nursing on patient-reported function after lower-limb arthroplasty and to explore effect modification by surgical procedure and by technological modality.MethodsTen databases were searched from inception to 2 May 2025. Randomised controlled trials (RCTs) comparing an innovative digital or electromechanical rehabilitation intervention with usual postoperative care and reporting WOMAC, KOOS or HOOS outcomes were eligible. Risk of bias was assessed with Cochrane RoB 2.0. Standardised mean differences (Hedges g) were pooled using a Hartung-Knapp REML random-effects model; heterogeneity was quantified with I². Sub-group analyses were prespecified for surgery type (TKA vs THA) and technology class (virtual reality VR, web/app telerehabilitation WB, robot/sensor RB). Publication bias was evaluated with funnel-plot inspection and Egger's regression. The certainty of evidence was assessed with the GRADE framework.ResultsFifteen RCTs (1012 experimental, 954 control participants; 11 TKA, 3 THA, 1 mixed) met the criteria and were all rated overall \"low risk\" by RoB 2.0. Across trials, technology-enabled care conferred a small but significant improvement in patient-reported function (g = 0.28; 95% CI 0.00 to 0.56; p = 0.049; I² = 86%). VR produced the largest point estimate (g = 0.62; 95% CI -0.18 to 1.41; 4 trials); WB yielded a modest, non-significant benefit (g = 0.18; 95% CI -0.24 to 0.59; 8 trials); RB showed a comparable, non-significant effect (g = 0.14; 95% CI -0.23 to 0.50; 3 trials). The χ² test for subgroup differences was not significant (p = 0.16). Egger's test revealed no evidence of small-study effects (p = 0.73). Leave-one-out and influence analyses confirmed robustness of the pooled estimate. The certainty of evidence was rated as moderate (GRADE).ConclusionsNext-generation digital and electromechanical rehabilitation programmes achieve at least non-inferior- and potentially clinically relevant-improvements in self-reported function after lower-limb arthroplasty while reducing in-person therapist time. Virtual-reality platforms appear most promising, but heterogeneity suggests that dose, feedback fidelity and sensor precision are key effect drivers. Large, standardised multicentre trials with cost-utility endpoints are needed to clarify which technological components add value for which patients.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"641-653"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-of-system approach for program implementation: Lessons from the Australian Teletrial Program.","authors":"Sabe Sabesan, Shivan Pathmanathan, Melanie Poxton","doi":"10.1177/1357633X261475898","DOIUrl":"https://doi.org/10.1177/1357633X261475898","url":null,"abstract":"<p><p>Decentralized clinical trial (DCT) methods have evolved globally to improve access to clinical trials for rural, regional, and other underserved populations. Several countries, including Australia, have implemented DCT approaches with variable success.In Australia, the Australian Teletrial Model was developed and adopted as a national policy initiative to improve equitable access to clinical trials. The Australian Teletrial Program, funded by the Commonwealth Government, supported implementation across jurisdictions and health services.The program achieved several important outcomes, including the development of harmonized templates and processes, standard operating procedures, and education and training programs. It also improved patient access to trials and strengthened workforce capability across participating sites.Despite these achievements, several barriers continue to limit broader implementation and sustainability. These include workforce turnover, cumbersome approval processes, variable uptake across different levels of the health system and sponsors, and inconsistent leadership engagement and ownership. Such challenges have constrained scale and productivity.To fully realize the benefits of DCT models and support health equity objectives, a whole-of-system approach is required. Streamlined policies and processes, aligned governance, and sustained leadership commitment are needed to embed decentralized clinical trial models into routine healthcare delivery and ensure long-term sustainability, productivity, and equitable access to clinical research.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X261475898"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of telerehabilitation monitored home-based therapies on upper extremity function-related outcomes in children and adolescents with unilateral cerebral palsy: A systematic review.","authors":"Jibrin Sammani Usman, Thomson Wai-Lung Wong, Shamay Sheung Mei Ng","doi":"10.1177/1357633X261420104","DOIUrl":"10.1177/1357633X261420104","url":null,"abstract":"<p><strong>Introduction: </strong>Children and adolescents with cerebral palsy (CP) demonstrate proficient function if they can perform all tasks required for daily living. Telerehabilitation (TR) and monitoring can facilitate the execution of home-based (HB) therapies. This systematic review aimed to assess the scientific evidence regarding the effects of TR-monitored HB therapies on outcomes related to upper extremity function in children and adolescents with unilateral cerebral palsy (UCP).MethodsComprehensive searches were conducted across online databases, including the Cochrane Library, EMBASE, PubMed, Web of Science, and PEDro, as well as additional sources, from inception to October 2025. The inclusion criteria encompassed randomized controlled trials, whose risk of bias and methodological quality were evaluated using the Cochrane Risk-of-Bias Tool and the PEDro scale, respectively. A narrative synthesis approach was employed for data analysis.ResultsTR-monitored HB therapies showed positive improvements in hand coordination, dexterity, bimanual hand function, ADL motor and processing skills, occupational performance, and execution of functional goals in children and adolescents with UCP (predominantly spastic UCP studies) compared with the control interventions.ConclusionsTelerehabilitation-monitored HB therapies showed potential to improve upper extremity function-related outcomes in children and adolescents with unilateral cerebral palsy (predominantly spastic UCP studies).</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"654-668"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}