JMIR Publications

ABSTRACT

Background:

Several systematic reviews assessing the use of telemedicine for musculoskeletal conditions have been published in last years. However, the landscape of evidence on multiple clinical outcomes remained unclear.

Objective:

To summarize the available evidence from systematic reviews (SRs) on telemedicine in musculoskeletal disorders.

Methods:

We conducted an overview of SRs searching PubMed and EMBASE up to July 25, 2022 for SRs of randomized controlled trials assessing telemedicine. We collected any kind of patient-reported outcomes measurements (PROMS), patient-reported experience measurements (PREMS) and objective measures, including direct and indirect costs. We assessed the methodological quality by A Measurement Tool to Assess Reviews 2 (AMSTAR 2). Findings were reported qualitatively.

Results:

Overall, 35 SRs published between 2015 and 2022 were included. Most reviews (68.6%) were rated as critically low by AMSTAR 2. The majority of reviews assessed “telerehabilitation” (n=29) in patients with osteoarthritis (n=13) using PROMs (n=142 outcomes mapped with 60 meta-analyses). A substantive body of evidence meta-analyzed found telemedicine to benefit or being equal in terms of PROMs compared to conventional care (n=57 meta-analyses). Meta-analyses showed no differences between groups in PREMs (n=4), while objectives measure (i.e. ‘physical function’) were mainly in favour of telemedicine or showing no differences (9 out of 13). All SRs showed significant lower costs for telemedicine compared to in-person visit.

Conclusions:

Telemedicine can provide more accessible health care with non-inferior results in various clinical outcomes in comparison with conventional care. The assessment of telemedicine is largely represented by PROMs with some gaps for PREMs, objective measures and costs. Clinical Trial: PROSPERO n° CRD42022347366 and https://osf.io/pxedm/.