Televisits Compared With In-Person Visits for Routine Antenatal Care: A Systematic Review.
| Autor: | Balk EM; Center for Evidence Synthesis in Health and the Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; the Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; the Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China; and the Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor., Danilack VA, Cao W, Bhuma MR, Adam GP, Konnyu KJ, Peahl AF |
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| Jazyk: | angličtina |
| Zdroj: | Obstetrics and gynecology [Obstet Gynecol] 2023 Jul 01; Vol. 142 (1), pp. 19-29. Date of Electronic Publication: 2023 Jun 07. |
| DOI: | 10.1097/AOG.0000000000005194 |
| Abstrakt: | Objective: To compare benefits and harms of televisits and in-person visits in people receiving routine antenatal care. Data Sources: A search was conducted of PubMed, Cochrane databases, EMBASE, CINAHL, and ClinicalTrials.gov through February 12, 2022, for antenatal (prenatal) care, pregnancy, obstetrics, telemedicine, remote care, smartphones, telemonitoring, and related terms, as well as primary study designs. The search was restricted to high-income countries. Methods of Study Selection: Double independent screening was done in Abstrackr for studies comparing televisits and in-person routine antenatal care visits for maternal, child, health care utilization, and harm outcomes. Data were extracted into SRDRplus with review by a second researcher. Tabulation, Integration, and Results: Two randomized controlled trials, four nonrandomized comparative studies, and one survey compared visit types between 2004 and 2020, three of which were conducted during the coronavirus disease 2019 (COVID-19) pandemic. Number, timing, and mode of televisits and who provided care varied across studies. Low-strength evidence from studies comparing hybrid (televisits and in-person visits) and all in-person visits did not indicate differences in rates of neonatal intensive care unit admission of the newborn (summary odds ratio [OR] 1.02, 95% CI 0.82-1.28) or preterm births (summary OR 0.93, 95% CI 0.84-1.03). However, the studies with stronger, although still statistically nonsignificant, associations between use of hybrid visits and preterm birth compared the COVID-19 pandemic and prepandemic eras, confounding the association. There is low-strength evidence that satisfaction with overall antenatal care was greater in people who were pregnant and receiving hybrid visits. Other outcomes were sparsely reported. Conclusion: People who are pregnant may prefer hybrid televisits and in-person visits. Although there is no evidence of differences in clinical outcomes between hybrid visits and in-person visits, the evidence is insufficient to evaluate most outcomes. Systematic Review Registration: PROSPERO, CRD42021272287. Competing Interests: Financial Disclosure Alex Friedman Peahl is a paid consultant for Maven Clinic. The other authors did not report any potential conflicts of interest. (Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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