• Beatriz Pascual-de la Pisa, Marta Palou-Lobato, Cristina Márquez Calzada, and María José García-Lozano.
• Unidad de Gestión Clínica de Camas, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Camas, Sevilla, España; Departamento de Medicina, Facultad de Medicina de Sevilla, Sevilla, España. Electronic address: beatriz.pascual.pisa@gmail.com.
• Aten Primaria. 2020 Dec 1; 52 (10): 759-769.

ObjectiveTo evaluate the effectiveness of telemedicine interventions to improve health outcomes in patients with multiple morbidities in Primary Health Care.DesignA systematic review.Data SourcesINAHTA, Health Guidelines, NICE, Cochrane Library, Medline/PubMed and EMBASE up to April 2018.Study SelectionInclusion criteria: patients (adults with 2 or more chronic diseases or a Charlson index greater than three); intervention (telemedicine intervention developed entirely in Primary Health Care); comparator (usual care); health outcomes (mortality, hospital admissions, emergency department visits, health-related quality of life, and satisfaction); study design(clinical practice guideline, systematic review, meta-analysis, randomised controlled clinical trial),and quasi-experimental design). English and Spanish language publication. A total of236 references were located.Data ExtractionDuplicated articles were removed. Titles, abstracts, and full text of references identified were assessed using the selection criteria; methodological quality assessment; data extraction, and qualitative analysis.ResultsFive articles, corresponding to 3 studies, were included, with 2 randomised controlled clinical trials and one quasi-experimental design. No significant results were observed in reducing mortality or improving health-related quality of life. The effectiveness of telemedicine on the number of hospital admissions or emergency visits showed contradictory results. Satisfaction was not measured in the studies included.ConclusionsThe relatively small number of studies, heterogeneity characteristics, and methodological limitations did not confirm the effectiveness of telemedicine intervention on the improvement of mortality, number of hospital admissions, emergency department visits, and health-related quality of life, compared to usual care.Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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