천식 환자의 원격의료 중재의 체계적 문헌고찰 개관

다국어 초록 (Multilingual Abstract)

Objectives: The aim of the overview was to synthesize the current evidence of published systematic reviews (SRs) addressing telehealth intervention for asthma patients.
Methods: We searched MEDLINE, EMBASE, and Cochrane database of systematic review (CDSR), other reviews (DARE), technology assessments (HTA), Economic evaluations (EED) up to March 2016. By two authors independently, SRs were selected based on predefined inclusion criteria. Only English or Korean articles published after 2010 were selected. The outcomes of interest were clinical outcome (i.e., asthma symptoms, quality of life, health utilization, etc), associated costs and factors influencing the adoption of telehealth. Narrative analysis for the selected articles was conducted.
Results: We included 8 SRs to examine the effect of telehealth in patients with asthma. There were no clinical variables such as asthma control, quality of life, use of medical services, pulmonary function, side effect and compliance reported consistent improvement in telehealth group compared with usual care. As a result of analyzing number of clinic visit, the increasing tendency appeared in telehealth group compared with control group, the medical cost was less expensive. Taken together with the number of clinic visit and medical cost, there was no difference between groups. In the economic aspect, we reviewed the medical cost per visit and cost-effectiveness of the telehealth. Upon examination of medical cost per visit, the medical cost of telehealth was lower, and annual medical cost appeared also to be less. Cost-effectiveness was different according to target population (adults, children).
Conclusion: The use of telehealth for asthma was unlikely to result in statistically significant improvements in health outcomes.
To clarify the effectiveness of telehealth for asthma, further researches are needed with the well-defined intervention and outcome variables.