Limits...
Effect of telemedicine follow-up care of leg and foot ulcers: a systematic review.

Nordheim LV, Haavind MT, Iversen MM - BMC Health Serv Res (2014)

Bottom Line: The study (n = 140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations.There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up.There is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Leg ulcers and diabetes-related foot ulcers are frequent and costly complications of their underlying diseases and thus represent a critical issue for public health. Since the population is aging, the prevalence of these conditions will probably increase considerably and require more resources. Treatment of leg and foot ulcers often demands frequent contact with the health care system, may pose great burden on the patient, and involves follow-up in both primary and specialist care. Telemedicine provides potential for more effective care management of leg and foot ulcers. The objective of this systematic review of the literature was to assess the effect of telemedicine follow-up care on clinical, behavioral or organizational outcomes among patients with leg and foot ulcers.

Methods: We searched Ovid MEDLINE (1980-), Ovid EMBASE (1980-), Clinical Trials in the Cochrane Library (via Wiley), Ebsco CINAHL with Fulltext (1981-) and SveMed + (1977-) up to May 2014 for relevant articles. We considered randomized controlled trials, non-randomized trials, controlled before-after studies and prospective cohort studies for inclusion and selected studies according to predefined criteria. Three reviewers independently assessed the included studies using the Cochrane Collaboration risk-of-bias tool. We performed a narrative synthesis of results and assessed the strength of evidence for each outcome using GRADE (grading of recommendations, assessment, development and evaluation).

Results: Only one non-randomized study was included. The study (n = 140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations. There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up. We assessed the study to have a high risk of bias.

Conclusions: There is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up.

No MeSH data available.


Related in: MedlinePlus

Flow chart of study selection process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4230629&req=5

Fig1: Flow chart of study selection process.

Mentions: Electronic searches resulted in 3590 citations. Of these, 224 duplicates were removed and 3346 citations were excluded after reviewing the titles and abstracts. We obtained and read the full text of the remaining 20 citations. We excluded 19 citations due to the following reasons: not a study (n = 8), multiple reasons for exclusion (i.e. more than one inclusion criteria not met; n = 2), irrelevant study design (n = 4), mixed population and separate outcome data not available (n = 4), and irrelevant intervention (n = 1). Details for excluded studies in all but the first exclusion category are provided in Table 2 [28-32,41-46]. Contact with experts did not identify further studies. Eventually, only one study [47] was included in the review (Figure 1).Table 2


Effect of telemedicine follow-up care of leg and foot ulcers: a systematic review.

Nordheim LV, Haavind MT, Iversen MM - BMC Health Serv Res (2014)

Flow chart of study selection process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230629&req=5

Fig1: Flow chart of study selection process.
Mentions: Electronic searches resulted in 3590 citations. Of these, 224 duplicates were removed and 3346 citations were excluded after reviewing the titles and abstracts. We obtained and read the full text of the remaining 20 citations. We excluded 19 citations due to the following reasons: not a study (n = 8), multiple reasons for exclusion (i.e. more than one inclusion criteria not met; n = 2), irrelevant study design (n = 4), mixed population and separate outcome data not available (n = 4), and irrelevant intervention (n = 1). Details for excluded studies in all but the first exclusion category are provided in Table 2 [28-32,41-46]. Contact with experts did not identify further studies. Eventually, only one study [47] was included in the review (Figure 1).Table 2

Bottom Line: The study (n = 140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations.There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up.There is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Leg ulcers and diabetes-related foot ulcers are frequent and costly complications of their underlying diseases and thus represent a critical issue for public health. Since the population is aging, the prevalence of these conditions will probably increase considerably and require more resources. Treatment of leg and foot ulcers often demands frequent contact with the health care system, may pose great burden on the patient, and involves follow-up in both primary and specialist care. Telemedicine provides potential for more effective care management of leg and foot ulcers. The objective of this systematic review of the literature was to assess the effect of telemedicine follow-up care on clinical, behavioral or organizational outcomes among patients with leg and foot ulcers.

Methods: We searched Ovid MEDLINE (1980-), Ovid EMBASE (1980-), Clinical Trials in the Cochrane Library (via Wiley), Ebsco CINAHL with Fulltext (1981-) and SveMed + (1977-) up to May 2014 for relevant articles. We considered randomized controlled trials, non-randomized trials, controlled before-after studies and prospective cohort studies for inclusion and selected studies according to predefined criteria. Three reviewers independently assessed the included studies using the Cochrane Collaboration risk-of-bias tool. We performed a narrative synthesis of results and assessed the strength of evidence for each outcome using GRADE (grading of recommendations, assessment, development and evaluation).

Results: Only one non-randomized study was included. The study (n = 140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations. There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up. We assessed the study to have a high risk of bias.

Conclusions: There is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up.

No MeSH data available.


Related in: MedlinePlus