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