JMIR Publications

ABSTRACT

Background:

Telemedicine modalities, such as video conferencing, are used by healthcare providers to remotely deliver healthcare to patients. The use of telemedicine in pediatrics has increased in recent years to improve healthcare access, optimize disease management, monitor progress of health conditions, and minimize exposure to sick patients during pandemics, such as coronavirus disease-19 (COVID-19).

Objective:

To synthesize information from recent randomized control trials regarding the use of telemedicine or telehealth across all health conditions in the pediatric populations.

Methods:

Studies were identified through PubMed database on May 10, 2020. We followed the guidelines for the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Included studies were randomized control trials from the last ten years that focused on telemedicine or telehealth approaches as a study intervention in general or sub-specialty pediatric care. Title and abstracts were independently screened based on the eligibility criteria. Full texts were retrieved and independently screened based on the eligibility criteria. A standardized form including publication title, first author’s name, publication year, participants’ characteristics, study design, technology approach used, intervention characteristics, study goal, and study findings was used for data extraction.

Results:

Eleven articles met inclusion criteria and were included in this review. All studies were categorized as either randomized control trials (8/11) or cluster randomized trials (3/11). Number of participants in each study ranged from 22 to 400. Health conditions ranged from obesity (3/11), asthma (2/11), mental health (1/11), otitis media (1/11), skin conditions (1/11), type I diabetes (1/11), ADHD (1/11), and cystic fibrosis related pancreatic insufficiency (1/11). Telemedicine approaches used included traditional patient and doctor visits conducted via videoconferencing (5/11), smartphone-based interventions (3/11), telephone counseling (2/11), and telemedicine screening visits (1/11). Telemedicine interventions in all included studies showed comparable or improved outcomes related to symptom management, quality of life, satisfaction, medication adherence, visit completion rates, and disease progression, compared to control groups.

Conclusions:

Evidence suggests that telemedicine use in general and subspecialty pediatric care is comparable and occasionally more beneficial, compared to in person visits. Patients, healthcare professionals, patients and caregivers may benefit from utilizing telemedicine alongside traditional in person healthcare evaluations. Future research should emphasize improving access to care and cost effectiveness and eliminating barriers of telemedicine use to maximize its potential. Clinical Trial: N/A