Accepted for/Published in: JMIR Medical Informatics
Date Submitted: May 17, 2020
Date Accepted: Jul 6, 2020
Barriers to Utilizing and Medical Outcomes Commensurate with the Use of Telehealth Among Older Adults: A Systematic Review
ABSTRACT
Background:
Background:
Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously, at the present.
Objective:
This review seeks to identify the barriers that prevent ubiquitous use as well as ways in which telehealth improves health outcomes and quality of life indicators for older adults.
Methods:
This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Reviewers queried four research databases: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct) research databases. Reviewers analyzed 64 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature.
Results:
Reviewers analyzed 57 studies across five interventions of telehealth: eHealth, mHealth, tele-monitoring, telecare (phone), and telemedicine video calls. Reviewers identified fourteen themes for barriers: The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified thirteen medical outcomes associated with telehealth intervention: The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%) and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%).
Conclusions:
The literature suggests the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, thereby reaching the population with more chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. Clinical Trial: This review was registered with PROSPERO.
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