Computer- and Telephone-Delivered Interventions on Patient Outcomes and Resource Utilization in Patients With Orthopaedic Conditions

Abstract

BACKGROUND: As the number of patients with orthopaedic conditions has risen continuously, hospital-based healthcare resources have become limited. Delivery of additional services is needed to adapt to this trend. PURPOSE: The purpose of this study was to describe the current literature of computer- and telephone-delivered interventions on patient outcomes and resource utilization in patients with orthopaedic conditions. METHODS: The systematic review was conducted in January 2019. The standardized checklist for randomized controlled trials was used to assess the quality of the relevant studies. A meta-analysis was not possible due to heterogeneity in the included studies, and a narrative synthesis was conducted to draw informative conclusions relevant to current research, policy, and practice. RESULTS: A total of 1,173 articles were retrieved. Six randomized controlled trials met the inclusion criteria, providing evidence from 434 individuals across four countries. Two studies reported findings of computer-delivered interventions and four reported findings of telephone-delivered interventions. The patients who received both computer- and telephone-delivered interventions showed improvements in patient outcomes that were similar or better to those of patients receiving conventional care. This was without any increase in adverse events or costs. CONCLUSION: Computer- and telephone-delivered interventions are promising and safe alternatives to conventional care. This review, however, identifies a gap in evidence of high-quality studies exploring the effects of computer- and telephone-delivered interventions on patient outcomes and resource utilization. In future, these interventions should be evaluated from the perspective of intervention content, self-management, and patient empowerment. In addition, they should consider the whole care journey and the development of the newest technological innovations. Additionally, future surgery studies should take into account the personalized needs of special, high-risk patient groups and focus on patient-centric care to reduce postdischarge health problems and resource utilization in this population.

Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review

“…Fifty-nine articles met the inclusion criteria and were considered for the analysis. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 The excluded thirty-four papers were editorials, letters, duplicate entries, and articles with no discussion on telemedicine even in the full text ( Figure 1 ). The monthly contributions trend of the orthopaedic telemedicine-related articles is shown in Figure 2 .…”

“…Jansson et al. 47 highlighted the need for higher-level evidence, technological innovation, and specialised patient-specific care for the at-risk population.…”

Towards digital counselling in primary care management of symptomatic knee osteoarthritis: a qualitative descriptive study in Finnish primary care

“…Our results pinpoint cost-related access barriers to health care, whereas digital care pathways could enable more cost-efficient, tailored, and targeted health information delivery in various formats to build patient-centric care. Although eHealth solutions have the potential to improve health outcomes, performance, and accountability [16,17] they can also exacerbate existing health disparities [27,28,29]. For that reason, health technology assessments must include consideration of equity to demonstrate value [30].…”

“…Although the virtual hospital initiative in Finland has already started to develop digital care pathways for citizens, HCPs, and patients in digital health conditions [15], there is a complete lack of targeted and tailored solutions covering the whole KOA pathway from admission to discharge and beyond, which is especially important for people with chronic and long-term conditions such as KOA [16,17]. In addition, there is a lack of knowledge on how to create value for patients themselves [13] whereas improvements in early diagnostics and clinical decision-making have improved performance (e.g., outcomes) and accountability (e.g., costs) in primary and secondary care management of symptomatic OA [18,19].…”

“…This qualitative descriptive study is part of a Co-innovation project that co-designs [5,18,19] and evaluates [16,17,20] the effects of new eHealth solutions, together with customers, companies, and academia. The aim of the present study is to identify patients' eHealth needs to improve the quality of counselling in a primary care management of symptomatic KOA.…”