Telehealth-use in the care of Patients with Myocardial Ischemia : A Scoping Review Dy, May
Background: Heart disease is the second leading cause of death after cancer and the leading cause of hospitalization in Canada.1 This patient population faces healthcare access issues for treatment and follow-up. Telehealth may be a possible solution. Objective: To explore, map, and summarize the current state of literature related to telehealth use in myocardial ischemia. Methods: A scoping review was conducted on literature available from January 2014 to January 2019. Three databases were searched, and grey literature was identified using the Google Scholar search engine. Literature was considered for inclusion if it (1) was published in English; (2) was related to patients with myocardial ischemia from common causes; (3) reported on telehealth development or use; (4) included a patient and healthcare professional interaction; and (5) was limited to adult populations. Results: Thirteen research articles met the inclusion criteria. Randomized control trials (n=7) and systematic reviews (n=4) were most common. Most of the literature focused on North American (n=4) and European countries (n=4), although some focused on more than one geographic area (n=4). The majority of the articles used more than one type of telehealth intervention, such as a combination of: telephone, text messaging, live video chat/video conferencing, email, and physiologic measures. Three main areas of investigation were addressed through telehealth use: (1) healthcare access issues, (2) low adherence to traditional rehabilitative programs, and (3) telemonitoring of physiologic data. Future research should analyze which components of telehealth cardiac rehabilitation are most beneficial, and identify settings in which preventative efforts are deemed ineffective. Conclusion: The existing literature suggests that telehealth is primarily used for the secondary prevention of coronary artery disease, and its use is increasing as technologies evolve and internet use becomes more commonplace. Telehealth has the potential to reduce travel burden, provide access to a wider range of specialist advice, and deliver faster and more efficient care. There are several considerations for researchers and clinicians when designing interventions to improve access and adherence to care for patients with ischemic heart disease.
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