JMIR Publications

ABSTRACT

Background:

Telehealth has been established as a strategy to provide health care for patients with hypertension and diabetes from the COVID-19 pandemic onward. However, little is known about its usability from a healthcare professional's perspective.

Objective:

To assess evidence on health professionals’ perceptions of the usability of telehealth systems in primary care of individuals with hypertension and diabetes from the COVID-19 pandemic onward.

Methods:

A systematic review of the prospective cohort, retrospective, and qualitative studies, published in English, Spanish and Portuguese since March 2020. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Eligibility criteria were health professionals: (1) who use telehealth systems, (2) are based in primary care, (3) manage patients with hypertension and diabetes, and (4) from the COVID-19 pandemic onward. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles, and risk of bias assessments was completed accordingly. The primary outcome was telehealth systems usability, while secondary outcomes were satisfaction and the contexts in which the telehealth system was used. The risk of bias and methodological quality of the included studies were analyzed.

Results:

Eleven of the 417 retrieved studies were included, reporting data from 248 healthcare professionals with previous experience in telehealth for hypertension and diabetes. The studies were from high-income and middle-income countries only. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems good and felt comfortable and satisfied using them for patients with hypertension and diabetes in primary care. Ease of use was cited as the most important predictor for using digital health technologies. The main barriers identified to the use of telehealth in primary care were technological challenges, low computer skills, lack of equipment, inability to perform comprehensive physical examinations, lack of training, security flaws, regulatory issues, scheduling difficulties, and time spent on the scheduling of new patients, lack of integration with other practices or members of the health team, language/cultural barriers, and connectivity problems. The main limitation of this study was the potential impact of differences between health systems in different contexts and countries in the arisen evidence.

Conclusions:

The favorable perception of professionals about telehealth systems pointed to progress in digital healthcare experiences to manage non-communicable diseases in pandemic times. Clinical Trial: This research is funded by the Worldwide Universities Network (WUN RESEARCH PROJECTS), as part of the project: Leveraging digital healthcare experiences for post-pandemic non-communicable disease research - a multidisciplinary network engaging Brazil, Ghana, and the UK, and the study protocol was registered with PROSPERO International Prospective Register of Systematic Reviews CRD42021296887, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=296887