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Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review
BACKGROUND: Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. OBJECTIVE: This review aimed to identify the barriers that prevent ubiquitous use of telehealth a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450384/ https://www.ncbi.nlm.nih.gov/pubmed/32784177 http://dx.doi.org/10.2196/20359 |
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author | Kruse, Clemens Fohn, Joanna Wilson, Nakia Nunez Patlan, Evangelina Zipp, Stephanie Mileski, Michael |
author_facet | Kruse, Clemens Fohn, Joanna Wilson, Nakia Nunez Patlan, Evangelina Zipp, Stephanie Mileski, Michael |
author_sort | Kruse, Clemens |
collection | PubMed |
description | BACKGROUND: Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. OBJECTIVE: This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. METHODS: This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. RESULTS: Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). CONCLUSIONS: The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. TRIAL REGISTRATION: PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/15490 |
format | Online Article Text |
id | pubmed-7450384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-74503842020-08-31 Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review Kruse, Clemens Fohn, Joanna Wilson, Nakia Nunez Patlan, Evangelina Zipp, Stephanie Mileski, Michael JMIR Med Inform Review BACKGROUND: Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. OBJECTIVE: This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. METHODS: This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. RESULTS: Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). CONCLUSIONS: The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. TRIAL REGISTRATION: PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/15490 JMIR Publications 2020-08-12 /pmc/articles/PMC7450384/ /pubmed/32784177 http://dx.doi.org/10.2196/20359 Text en ©Clemens Kruse, Joanna Fohn, Nakia Wilson, Evangelina Nunez Patlan, Stephanie Zipp, Michael Mileski. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.08.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on http://medinform.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Review Kruse, Clemens Fohn, Joanna Wilson, Nakia Nunez Patlan, Evangelina Zipp, Stephanie Mileski, Michael Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title | Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title_full | Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title_fullStr | Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title_full_unstemmed | Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title_short | Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review |
title_sort | utilization barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450384/ https://www.ncbi.nlm.nih.gov/pubmed/32784177 http://dx.doi.org/10.2196/20359 |
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