• Chest · Jul 2024

    Review

    Determining if COPD Self-Management Televisit-Based Interventions are evaluated among and equitably effective across diverse patient populations to Reduce Acute Care Utilization: A Scoping Review.

    • Mahima Akula, May Nguyen, Joanna Abraham, Vineet M Arora, Folabomi Oladosu, Aashna Sunderrajan, Leah Traeger, and Valerie G Press.
    • Department of Medicine, University of Chicago, Chicago, IL.
    • Chest. 2024 Jul 11.

    Topic ImportanceWith telemedicine's expansion during the COVID-19 pandemic, it has become critical to evaluate whether patients have equitable access to and capabilities to use televisits optimally for improved COPD outcomes such as reduced hospitalizations. This scoping review evaluated whether televisit-based interventions are evaluated among and equitably effective in improving health care use outcomes among diverse patient populations with COPD.Review FindingsUsing a systematic search for televisit-based COPD self-management interventions, we found 20 studies for inclusion, all but one of which were published before the COVID-19 pandemic. Most (11 of 20) were considered good-quality studies. Most studies (19 of 20) reported age and sex; few provided race (3 of 20) or income (1 of 20) data. The most frequently used televisit-based methods were in-person plus phone (6 of 20), video only (6 of 20), and phone only (4 of 20). Most studies (12 of 20) showed a significant reduction in at least one health care use metric; nine studies found hospitalization-related reductions. Effective interventions typically used two methods (eg, in-person plus televisits), video methods, or both.SummaryMost studies failed to report on participants' race or income, leading to a lack of data on the equity of interventions' effectiveness across diverse patient populations. Multimethod televisit-based interventions, particularly with an in-person component, most commonly were effective; no associations were seen with study quality or size. With the increasing reliance on telemedicine to provide chronic disease care, the lack of data among diverse populations since the COVID-19 pandemic began limits generalizability of these findings for real-world clinical settings. More comprehensive evaluations of televisit-based interventions are needed in the era after the pandemic within and across diverse patient populations.Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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