Impact of telemedicine on health outcomes in children with medical complexity: an integrative review.
Children Chronic diseases
Health outcomes
Medical complexity
Special needs
Telehealth
Telemedicine
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
21
01
2021
accepted:
12
06
2021
revised:
10
06
2021
pubmed:
2
7
2021
medline:
21
7
2021
entrez:
1
7
2021
Statut:
ppublish
Résumé
Children with medical complexity (CMC) are a high priority population with chronic illnesses dependent on the use of health services, on technological systems to support their vital functions and characterized by multiple health needs. One of the main challenges linked to chronic conditions is finding solutions to monitor CMC at home, avoiding re-hospitalization and the onset of complications. Telemedicine enables to remotely follow up patients and families. An integrative review was performed to assess whether telemedicine improves health outcomes for CMC. Medline/PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus were searched to identify studies describing the effect of using telemedicine systems on health outcomes for CMC. The PRISMA guidelines were used to select the papers. The methodological quality of the studies was evaluated through the Johanna Briggs Institute critical appraisal tools and the Cochrane Collaboration ROB 2.0. A total of 17 papers met the quality criteria and were included. Specialized telemedicine systems (tele-visits), telehealth, and tele-monitoring have been reported to reduce unplanned hospitalizations and visits, decrease total costs for healthcare services and families, and increase satisfaction for family members. No effect was found on the quality of life in children and their families.Conclusion: Available evidence supporting the use of telemedicine in CMC is favorable but limited. High-quality methodological studies including other unexplored health outcomes such as mental health, hospital readmissions, mortality, caregiver competences, and self-efficacy are needed to confirm the effectiveness of telemedicine systems in improving health outcomes for CMC. What is Known: • CMC are an extremely fragile patient population with frequent access to healthcare services compared with other chronic conditions. • There is conflicting evidence of the effectiveness of telemedicine clinical outcomes, healthcare utilization, and costs in pediatrics. What is New: • There is some evidence that for CMC, telemedicine reduces unplanned hospitalizations, healthcare service costs, and financial burden for families, while increasing caregivers' satisfaction with care. • Further research is needed to confirm the effectiveness of telemedicine systems in improving health for CMC.
Identifiants
pubmed: 34196791
doi: 10.1007/s00431-021-04164-2
pii: 10.1007/s00431-021-04164-2
pmc: PMC8246433
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2389-2400Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Burns KH, Casey PH, Lyle RE, Bird TM, Fussell JJ, Robbins JM (2010) Increasing prevalence of medically complex children in US hospitals. Pediatrics 126:638–646. https://doi.org/10.1542/peds.2009-1658
doi: 10.1542/peds.2009-1658
pubmed: 20855383
Berry JG, Hall M, Neff J, Goodman D, Cohen E, Agrawal R, et al. Children with medical complexity and Medicaid: spending and cost savings. Health Aff (Millwood) 2014;33:2199–206. https://doi.org/10.1377/hlthaff.2014.0828 .
doi: 10.1377/hlthaff.2014.0828
Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SKM, Simon TD, et al. Children with medical complexity: an emerging population for clinical and research initiatives. PEDIATRICS 2011;127:529–38. https://doi.org/10.1542/peds.2010-0910 .
doi: 10.1542/peds.2010-0910
pubmed: 21339266
pmcid: 3387912
Berry JG, Agrawal RK, Cohen E, Kuo DZ (2013) The landscape of medical care for children with medical complexity
Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. PEDIATRICS 2012;130:e1463–70. https://doi.org/10.1542/peds.2012-0175 .
doi: 10.1542/peds.2012-0175
pubmed: 23184117
pmcid: 4528341
Berry JG, Agrawal R, Kuo DZ, Cohen E, Risko W, Hall M, et al. Characteristics of hospitalizations for patients who use a structured clinical care program for children with medical complexity. J Pediatr 2011;159:284–90. https://doi.org/10.1016/j.jpeds.2011.02.002 .
doi: 10.1016/j.jpeds.2011.02.002
pubmed: 21429511
pmcid: 3138997
Coller RJ, Rodean J, Linares DE, Chung PJ, Pulcini C, Hall M, et al. Variation in hospitalization rates following emergency department visits in children with medical complexity. The Journal of Pediatrics 2019;214:113-120.e1. https://doi.org/10.1016/j.jpeds.2019.07.034 .
doi: 10.1016/j.jpeds.2019.07.034
pubmed: 31540760
Russell CJ, Simon TD. Care of children with medical complexity in the hospital setting. Pediatr Ann 2014;43:e157-162. https://doi.org/10.3928/00904481-20140619-09 .
doi: 10.3928/00904481-20140619-09
pubmed: 24977678
Simon TD, Berry J, Feudtner C, Stone BL, Sheng X, Bratton SL, et al. Children with complex chronic conditions in inpatient hospital settings in the United States. Pediatrics 2010;126:647–55. https://doi.org/10.1542/peds.2009-3266 .
doi: 10.1542/peds.2009-3266
pubmed: 20855394
Berry JG, Hall M, Hall DE, Kuo DZ, Cohen E, Agrawal R, et al. Inpatient growth and resource use in 28 children’s hospitals. JAMA Pediatr 2013;167:170–7. https://doi.org/10.1001/jamapediatrics.2013.432 .
doi: 10.1001/jamapediatrics.2013.432
pubmed: 23266509
pmcid: 3663043
Hooshmand M, Yao K. Challenges facing children with special healthcare needs and their families: telemedicine as a bridge to care. Telemed J E Health 2017;23:18–24. https://doi.org/10.1089/tmj.2016.0055 .
doi: 10.1089/tmj.2016.0055
pubmed: 27305407
Karp WB, Grigsby RK, McSwiggan-Hardin M, Pursley-Crotteau S, Adams LN, Bell W, et al. Use of telemedicine for children with special health care needs. Pediatrics 2000;105:843–7.
doi: 10.1542/peds.105.4.843
American Telemedicine Association (ATA). Telemedicine, telehealth, and health information technology 2006.
Pordes E, Gordon J, Sanders LM, Cohen E. Models of care delivery for children with medical complexity. Pediatrics 2018;141:S212–23. https://doi.org/10.1542/peds.2017-1284F .
doi: 10.1542/peds.2017-1284F
pubmed: 29496972
Antonelli RC, Antonelli DM. Providing a medical home: the cost of care coordination services in a community-based, general pediatric practice. Pediatrics 2004;113:1522–8.
pubmed: 15121921
Cooley WC. Providing a primary care medical home for children and youth with cerebral palsy. Pediatrics 2004;114:1106–13.
doi: 10.1542/peds.2004-1409
Cooley WC, McAllister JW, Sherrieb K, Kuhlthau K. Improved outcomes associated with medical home implementation in pediatric primary care. Pediatrics 2009;124:358–64.
doi: 10.1542/peds.2008-2600
Cooley WC, McAllister JW. Building medical homes: improvement strategies in primary care for children with special health care needs. Pediatrics 2004;113:1499–506.
pubmed: 15121918
Hoff T, Weller W, DePuccio M. The patient-centered medical home: a review of recent research. Medical Care Research and Review 2012;69:619–44.
doi: 10.1177/1077558712447688
Perrin JM. Patient-centered medical home for high-risk children with chronic illness. Jama 2014;312:2625–6.Perrin JM. Patient-centered medical home for high-risk children with chronic illness. Jama 2014;312:2625–6.
doi: 10.1001/jama.2014.16514
Cady R, Kelly A, Finkelstein S. Home telehealth for children with special health-care needs. J Telemed Telecare 2008;14:173–7. https://doi.org/10.1258/jtt.2008.008042 .
doi: 10.1258/jtt.2008.008042
pubmed: 18534949
Farmer JE, Muhlenbruck L. Telehealth for children with special health care needs: promoting comprehensive systems of care. Clin Pediatr (Phila) 2001;40:93–8. https://doi.org/10.1177/000992280104000205 .
doi: 10.1177/000992280104000205
Edwards D, Noyes J, Lowes L, Spencer LH, Gregory JW. An ongoing struggle: a mixed-method systematic review of interventions, barriers and facilitators to achieving optimal self-care by children and young people with Type 1 Diabetes in educational settings. BMC PEDIATRICS 2014;14. https://doi.org/10.1186/1471-2431-14-228 .
Sheehy S, Cohen G, R Owen K. Self-management of diabetes in children and young adults using technology and smartphone applications. Current Diabetes Reviews 2014;10:298–301.
Shulman RM, O’Gorman CS, Palmert MR. The impact of telemedicine interventions involving routine transmission of blood glucose data with clinician feedback on metabolic control in youth with type 1 diabetes: a systematic review and meta-analysis. International Journal of Pediatric Endocrinology 2010;2010:1–9.
doi: 10.1155/2010/536957
Sun C, Malcolm JC, Wong B, Shorr R, Doyle M-A. Improving glycemic control in adults and children with type 1 diabetes with the use of smartphone-based mobile applications: a systematic review. Canadian Journal of Diabetes 2019;43:51–8.
doi: 10.1016/j.jcjd.2018.03.010
Wang Y, Xue H, Huang Y, Huang L, Zhang D. A systematic review of application and effectiveness of mHealth interventions for obesity and diabetes treatment and self-management. Advances in Nutrition 2017;8:449–62.
doi: 10.3945/an.116.014100
Huang X, Matricardi PM. Allergy and asthma care in the mobile phone era. Clinical Reviews in Allergy & Immunology 2019;56:161–73.
doi: 10.1007/s12016-016-8542-y
Kew KM, Cates CJ. Remote versus face-to-face check-ups for asthma. Cochrane Database of Systematic Reviews 2016.
Morrison D, Wyke S, Agur K, Cameron EJ, Docking RI, MacKenzie AM, et al. Digital asthma self-management interventions: a systematic review. Journal of Medical Internet Research 2014;16:e51.
Hammersley ML, Jones RA, Okely AD. Parent-focused childhood and adolescent overweight and obesity eHealth interventions: a systematic review and meta-analysis. Journal of Medical Internet Research 2016;18:e203.
Lee J, Piao M, Byun A, Kim J. A systematic review and meta-analysis of intervention for pediatric obesity using mobile technology. 2016.
Cox NS, Alison JA, Rasekaba T, Holland AE. Telehealth in cystic fibrosis: a systematic review. J Telemed Telecare 2012;18:72–8. https://doi.org/10.1258/jtt.2011.110705 .
doi: 10.1258/jtt.2011.110705
pubmed: 22198961
Cox NS, Alison JA, Holland AE. Interventions for promoting physical activity in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2013.
Goldbeck L, Fidika, A, Herle, M, Quittner A. Psychological interventions for individuals with cystic fibrosis and their families. Cochrane Database of Systematic Reviews 2014. https://doi.org/10.1002/14651858.CD003148.pub3 .
doi: 10.1002/14651858.CD003148.pub3
pubmed: 24941199
pmcid: 7388585
Grist R, Porter J, Stallard P. Mental health mobile apps for preadolescents and adolescents: a systematic review. J Med Internet Res 2017;19:e176. https://doi.org/10.2196/jmir.7332 .
doi: 10.2196/jmir.7332
pubmed: 28546138
pmcid: 5465380
Boisvert M, Lang R, Andrianopoulos M, Boscardin ML. Telepractice in the assessment and treatment of individuals with autism spectrum disorders: a systematic review. Dev Neurorehabil 2010;13:423–32. https://doi.org/10.3109/17518423.2010.499889 .
doi: 10.3109/17518423.2010.499889
pubmed: 20887200
Parsons D, Cordier R, Vaz S, Lee HC. Parent-mediated intervention training delivered remotely for children with autism spectrum disorder living outside of urban areas: systematic review. J Med Internet Res 2017;19:e198. https://doi.org/10.2196/jmir.6651 .
doi: 10.2196/jmir.6651
pubmed: 28807892
pmcid: 5575423
Sutherland R, Trembath D, Roberts J. Telehealth and autism: a systematic search and review of the literature. Int J Speech Lang Pathol 2018;20:324–36. https://doi.org/10.1080/17549507.2018.1465123 .
doi: 10.1080/17549507.2018.1465123
pubmed: 29709201
Fisher E, Law E, Dudeney J, Eccleston C, Palermo TM. Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents. Cochrane Database of Systematic Reviews 2019. https://doi.org/10.1002/14651858.CD011118.pub3 .
doi: 10.1002/14651858.CD011118.pub3
pubmed: 31041816
pmcid: 6759044
Tozzi AE, Carloni E, Gesualdo F, Russo L, Raponi M. Attitude of families of patients with genetic diseases to use m-health technologies. Telemedicine and E-Health 2015;21:86–9. https://doi.org/10.1089/tmj.2014.0080 .
doi: 10.1089/tmj.2014.0080
pubmed: 25469727
Wong CA, Ming D, Maslow G, Gifford EJ. Mitigating the impacts of the COVID-19 pandemic response on at-risk children. Pediatrics 2020;146:e20200973. https://doi.org/10.1542/peds.2020-0973 .
doi: 10.1542/peds.2020-0973
pubmed: 32317311
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6:e1000100. https://doi.org/10.1371/journal.pmed.1000100 .
doi: 10.1371/journal.pmed.1000100
pubmed: 19621070
pmcid: 2707010
Whittemore R, Knafl K. The integrative review: updated methodology. Journal of Advanced Nursing 2005;52:546–53. https://doi.org/10.1111/j.1365-2648.2005.03621.x .
doi: 10.1111/j.1365-2648.2005.03621.x
pubmed: 16268861
Aromataris E, Munn Z. Appendix 2.3: Qualitative data extraction Tool 2020;JBI Manual for Evidence Synthesis. https://doi.org/10.46658/JBIMES-20-01 .
Pearson A, Field J, Jordan Z. Appendix 3: Data extraction tools 2006: Evidence-based clinical practice in nursing and health care: assimilating research, experience and expertise. https://doi.org/10.1002/9781444316544.app3 .
Barnert ES, Coller RJ, Nelson BB, Thompson LR, Tran J, Chan V, et al. Key population health outcomes for children with medical complexity: a systematic review. Matern Child Health J 2019;23:1167–76. https://doi.org/10.1007/s10995-019-02752-1 .
doi: 10.1007/s10995-019-02752-1
pubmed: 31218608
Looman WS, Antolick M, Cady RG, Lunos SA, Garwick AE, Finkelstein SM. Effects of a telehealth care coordination intervention on perceptions of health care by caregivers of children with medical complexity: a randomized controlled trial. J Pediatr Health Care 2015;29:352–63. https://doi.org/10.1016/j.pedhc.2015.01.007 .
doi: 10.1016/j.pedhc.2015.01.007
pubmed: 25747391
pmcid: 4478110
Cady RG, Erickson M, Lunos S, Finkelstein SM, Looman W, Celebreeze M, et al. Meeting the needs of children with medical complexity using a telehealth advanced practice registered nurse care coordination model. Matern Child Health J 2015;19:1497–506. https://doi.org/10.1007/s10995-014-1654-1 .
doi: 10.1007/s10995-014-1654-1
pubmed: 25424455
pmcid: 4480777
McKissick HD, Cady RG, Looman WS, Finkelstein SM. The impact of telehealth and care coordination on the number and type of clinical visits for children with medical complexity. J Pediatr Health Care 2017;31:452–8. https://doi.org/10.1016/j.pedhc.2016.11.006 .
doi: 10.1016/j.pedhc.2016.11.006
pubmed: 28017489
Looman WS, Hullsiek RL, Pryor L, Mathiason MA, Finkelstein SM. Health-related quality of life outcomes of a telehealth care coordination intervention for children with medical complexity: a randomized controlled trial. J Pediatr Health Care 2018;32:63–75. https://doi.org/10.1016/j.pedhc.2017.07.007 .
doi: 10.1016/j.pedhc.2017.07.007
pubmed: 28870494
Robinson SS, Seale DE, Tiernan KM, Berg B. Use of telemedicine to follow special needs children. Telemed J E Health 2003;9:57–61. https://doi.org/10.1089/153056203763317657 .
doi: 10.1089/153056203763317657
pubmed: 12699608
Hooshmand M, Foronda C. Comparison of telemedicine to traditional face-to-face care for children with special needs: a quasiexperimental study. Telemed J E Health 2018;24:433–41. https://doi.org/10.1089/tmj.2017.0116 .
doi: 10.1089/tmj.2017.0116
pubmed: 29265922
Casavant DW, McManus ML, Parsons SK, Zurakowski D, Graham RJ. Trial of telemedicine for patients on home ventilator support: feasibility, confidence in clinical management and use in medical decision-making. J Telemed Telecare 2014;20:441–9. https://doi.org/10.1177/1357633X14555620 .
doi: 10.1177/1357633X14555620
pubmed: 25316042
Clawson B, Selden M, Lacks M, Deaton AV, Hall B, Bach R. Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program. Pediatr Nurs 2008;34:213–6.
pubmed: 18649810
Notario PM, Gentile E, Amidon M, Angst D, Lefaiver C, Webster K. Home-based telemedicine for children with medical complexity. Telemed J E Health 2019;25:1123–32. https://doi.org/10.1089/tmj.2018.0186 .
doi: 10.1089/tmj.2018.0186
pubmed: 30628860
pmcid: 6842894
Cormack CL, Garber K, Cristaldi K, Edlund B, Dodds C, McElligott L. Implementing school based telehealth for children with medical complexity. J Pediatr Rehabil Med 2016;9:237–40. https://doi.org/10.3233/PRM-160385 .
doi: 10.3233/PRM-160385
pubmed: 27612084
Cady R, Finkelstein S, Kelly A. A telehealth nursing intervention reduces hospitalizations in children with complex health conditions. J Telemed Telecare 2009;15:317–20. https://doi.org/10.1258/jtt.2009.090105 .
doi: 10.1258/jtt.2009.090105
pubmed: 19720770
Cady RG, Kelly AM, Finkelstein SM, Looman WS, Garwick AW. Attributes of advanced practice registered nurse care coordination for children with medical complexity. J Pediatr Health Care 2014;28:305–12. https://doi.org/10.1016/j.pedhc.2013.06.005 .
doi: 10.1016/j.pedhc.2013.06.005
pubmed: 23988611
Young NL, Barden W, McKeever P, Dick PT. Taking the call-bell home: a qualitative evaluation of Tele-HomeCare for children. Health & Social Care in the Community 2006;14:231–41. https://doi.org/10.1111/j.1365-2524.2006.00615.x .
doi: 10.1111/j.1365-2524.2006.00615.x
pubmed: 16650120
Young NL, Bennie J, Barden W, Dick PT. An examination of quality of life of children and parents during their Tele-HomeCare experience. Telemedicine and E-Health 2006;12:663–71. https://doi.org/10.1089/tmj.2006.12.663 .
doi: 10.1089/tmj.2006.12.663
pubmed: 17250488
Haney T, Tufts KA. A pilot study using electronic communication in home healthcare: implications on parental well-being and satisfaction caring for medically fragile children. Home Healthcare Nurse 2012;30:216–24. https://doi.org/10.1097/NHH.0b013e31824c28f2 .
doi: 10.1097/NHH.0b013e31824c28f2
pubmed: 22456459
Coller RJ, Nelson BB, Sklansky DJ, Saenz AA, Klitzner TS, Lerner CF, et al. Preventing hospitalizations in children with medical complexity: a systematic review. Pediatrics 2014;134:e1628–47. https://doi.org/10.1542/peds.2014-1956 .
doi: 10.1542/peds.2014-1956
pubmed: 25384492
Rickwood D, Wallace A, Kennedy V, O’Sullivan S, Telford N, Leicester S. Young people’s satisfaction with the online mental health service eheadspace: development and implementation of a service satisfaction measure. JMIR Ment Health 2019;6. https://doi.org/10.2196/12169 .
Johaningsmeir SA, Colby H, Krauthoefer M, Simpson P, Conceição SCO, Gordon JB. Impact of caring for children with medical complexity and high resource use on family quality of life. J Pediatr Rehabil Med 2015;8:75–82. https://doi.org/10.3233/PRM-150321 .
doi: 10.3233/PRM-150321
pubmed: 26409861
Ellzey A, Valentine KJ, Hagedorn C, Murphy NA. Parent perceptions of quality of life and healthcare satisfaction for children with medical complexity. J Pediatr Rehabil Med 2015;8:97–104. https://doi.org/10.3233/PRM-150323 .
doi: 10.3233/PRM-150323
pubmed: 26409863
Spaulding R, Cain S, Sonnenschein K. Urban telepsychiatry: uncommon service for a common need. Child Adolesc Psychiatr Clin N Am 2011;20:29–39. https://doi.org/10.1016/j.chc.2010.08.010 .
doi: 10.1016/j.chc.2010.08.010
pubmed: 21092910
Burke BL, Hall RW, Care the SOT. Telemedicine: pediatric applications. Pediatrics 2015;136:e293–308. https://doi.org/10.1542/peds.2015-1517 .
Dávalos ME, French MT, Burdick AE, Simmons SC. Economic evaluation of telemedicine: review of the literature and research guidelines for benefit–cost analysis. Telemedicine and E-Health 2009;15:933–48. https://doi.org/10.1089/tmj.2009.0067 .
doi: 10.1089/tmj.2009.0067
pubmed: 19954346
Doolittle GC, Spaulding AO, Williams AR. The decreasing cost of telemedicine and telehealth. Telemedicine and E-Health 2011;17:671–5. https://doi.org/10.1089/tmj.2011.0033 .
doi: 10.1089/tmj.2011.0033
pubmed: 22035320
Menon DU, Belcher HME. COVID-19 pandemic health disparities and pediatric health care—the promise of telehealth. JAMA Pediatr 2021;175:345–6. https://doi.org/10.1001/jamapediatrics.2020.5097 .
doi: 10.1001/jamapediatrics.2020.5097
pubmed: 33284346
Peters AL, Garg SK. The Silver Lining to COVID-19: Avoiding diabetic ketoacidosis admissions with telehealth. diabetes technology & therapeutics 2020;22:449–53. https://doi.org/10.1089/dia.2020.0187 .
Portnoy J, Waller M, Elliott T. Telemedicine in the era of COVID-19. The Journal of Allergy and Clinical Immunology: In Practice 2020;8:1489–91. https://doi.org/10.1016/j.jaip.2020.03.008 .
Patel PD, Cobb J, Wright D, Turer RW, Jordan T, Humphrey A, et al. Rapid development of telehealth capabilities within pediatric patient portal infrastructure for COVID-19 care: barriers, solutions, results. J Am Med Inform Assoc n.d. https://doi.org/10.1093/jamia/ocaa065 .