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Am J Kidney Dis. 2018 Oct;72(4):592-600. doi: 10.1053/j.ajkd.2018.02.353. Epub 2018 Apr 23.

Impact of Telehealth Interventions on Processes and Quality of Care for Patients With ESRD.

Author information

1
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
2
Department of Medicine, University of Alberta, Edmonton, Canada.
3
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
4
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: mjames@ucalgary.ca.

Abstract

Caring for patients with end-stage renal disease (ESRD) requiring dialysis is intensive and expensive. Telehealth may improve the access and efficiency of ESRD care. For this perspective, we systematically reviewed studies that examined the effectiveness of telehealth versus or in addition to usual care for ESRD management. 10 studies were identified, including 7 randomized trials and 3 cohort studies. Study populations, modes of delivery (including telephone, telemetry, or videoconferencing), and the outcomes evaluated varied substantially between studies. Two studies examined telehealth interventions versus standard ESRD care and demonstrated mixed results on processes of care, no differences in laboratory surrogate markers of ESRD care, and reduced or similar rates of hospitalization. Eight studies evaluated the addition of telehealth to usual care and demonstrated no significant improvements in processes of care or surrogate laboratory measures, variable impacts on hospitalization rates, and mixed impacts on some domains of quality of life, including improvement in mental health. Although potential benefits of telehealth in ESRD care have been reported, optimal designs for delivery and elements of care that may be improved through telehealth remain uncertain.

KEYWORDS:

End-stage renal disease (ESRD); dialysis; geographic barriers; health care delivery; health care technology; quality of life (QoL); remote monitoring; rural health; rural medicine; systematic review; telehealth; telemedicine; telemetry; telephone-supported care; videoconferencing

PMID:
29699884
DOI:
10.1053/j.ajkd.2018.02.353
[Indexed for MEDLINE]
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