JMIR Publications

ABSTRACT

Background:

In Canada, approximately 86,000 people live with spinal cord injury (SCI), and there are an estimated 3,675 new cases of traumatic or non-traumatic etiology per year. Most people with SCI will experience secondary health complications such as urinary and bowel issues, pain syndrome, pressure ulcers, and psychological disorders, resulting in severe chronic multimorbidity. Moreover, people with SCI may face barriers in accessing healthcare services such as lack of transportation, physical obstacles, and lack of preventative health screenings and primary care physician’s expert knowledge regarding secondary complications related to SCI. Telehealth, defined as the delivery of information and health-related services via telecommunication technologies, may help address some of these barriers and indeed, the present global COVID-19 pandemic has emphasized the importance of integration of telehealth in healthcare systems. As a result of this crisis, healthcare providers have increased the usage of telehealth services, providing health services to individuals in need of community-based supportive care. However, the evidence on models of telehealth service delivery for adults with SCI has not been previously synthesized.

Objective:

The purpose of this scoping review was to identify, describe, and compare models of telehealth services in community-dwelling adults with SCI.

Methods:

This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Studies published between 1990 to February 1st, 2022, were identified by searching Ovid Medline, Ovid Embase, Ovid Psycinfo, Web of Science, and CINAHL databases. Two investigators screened papers with specified inclusion criteria. Included articles focused on identifying, implementing, or evaluating telehealth interventions, including primary healthcare services and self-management services delivered in the community and home-based settings. One investigator performed a full-text review of each article, and data extraction included: (a) study characteristics, (b) participant characteristics, (c) key characteristics of the intervention/programs/ services, and (d) outcome measures and results.

Results:

A total of 57 articles reported telehealth services used for preventing, managing, or treating the most common secondary complications and consequences of SCI, including chronic pain, low physical activity, pressure ulcers, and psychosocial dysfunctioning. Where evidence exists, improvements in community participation, physical activity, and reduction in chronic pain, pressure ulcers, and psychosocial problems following SCI were demonstrated.

Conclusions:

Telehealth may offer an efficient and effective option for health service delivery for community-dwelling individuals with SCI, ensuring continuity of rehabilitation, follow-up after hospital discharge, and early detection, management, or treat potential secondary complications following SCI. We recommend further research to evaluate the effectiveness of telehealth interventions provided by a multidisciplinary team to integrate combined telecommunication modalities for patients with SCI. The findings of this scoping review may inform policymakers, healthcare professionals, and local/national stakeholders engaged in the planning, implementation, and delivery of virtual services for the SCI population.