Effectiveness of telemedicine psychoeducational interventions for adults with non-oncological chronic disease: A systematic review

Abstract

Aim: To evaluate the effectiveness of telemedicine psychoeducational interventions (PIs) in adult patients on the clinical management of chronic non-oncological diseases compared with another therapeutic option or no treatment.

Design: Systematic review of randomized controlled trials.

Data sources: Six databases were searched between January 2011 and August 2021.

Review methods: A systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study selection, quality appraisal and data extraction were conducted independently by two reviewers. A third arbiter was available if discrepancies.

Results: A total of 719 articles were reviewed and 17 studies met the inclusion and quality criteria. The included studies related to smoking, chronic pain, obesity and mental illness. Most interventions were based on cognitive behavioural theory. Most of the included studies (12/17, 70.5%) showed improvements in health and significant reductions in anxiety, pain and depression with variable effect sizes. Patients reported a high satisfaction rate and indicated lectures or self-report writings as helpful in their recovery compared with more interactive items. Only financial incentives demonstrated greater adherence. A specific intervention format or complementary professional support was not associated with health outcomes.

Conclusions: Telemedicine PIs are a safe and effective option for the clinical management of adults with chronic diseases. Future longitudinal studies are needed to assess the impact of these interventions on chronic physical and mental disease, evaluating the quality of life, morbidity and mortality.

Impact: The results reinforce the telemedicine PIs with effects on clinical management similar to those of the face-to-face modality and can be carried out in a safe environment for patients at a lower cost to the health system. These conditions make them suitable for comprehensive care in the epidemiological COVID-19 context with the highest safety conditions for the patients and professionals.

Keywords: chronic illness; clinical effectiveness; empowerment; health education; information technology; patient participation; psychosocial nursing; self-care; systematic reviews and meta-analyses; telenursing.