Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 3, 2023
Date Accepted: Feb 28, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effects of Telemedicine on Informal Caregivers of Palliative Care Patients: A Systematic Review and Meta-analysis.
ABSTRACT
Background:
Telemedicine technology is a rapidly developing field that demonstrates immense potential in improving medical services. With palliative care, informal caregivers assume the primary responsibility in patient care and often face challenges such as increased physical and mental stress and declining health. In such cases, telemedicine interventions can provide support, meet the needs of informal caregivers, and improve their health outcomes. However, research findings regarding the usage of telemedicine among informal caregivers of palliative patients are controversial, and its efficacy remains unclear.
Objective:
This study aimed to evaluate the impacts of telemedicine on managing burden, anxiety, depression, and quality of life among informal caregivers of palliative care.
Methods:
A literature search was conducted in ten electronic databases, including PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL Plus with Full-Text, CBM, CNKI, WanFang, and VIP, for publications from the date of establishment of each database through March 31, 2023. Two authors independently screened the studies and extracted relevant information. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs). Standardized mean difference (SMD) was calculated using Review Manager 5.4 to estimate the intervention effects, along with sensitivity analyses to examine the robustness of the combined results.
Results:
A total of nine RCTs were included in this study. The meta-analysis indicated that telemedicine has relaxed caregiving burden (SMD = -0.49, 95%CI [-0.72, -0.27], P <.001) and anxiety (SMD = -0.23, 95%CI [-0.40, -0.06], P=.01) of informal caregivers; however, it did not affect depression (SMD = -0.21, 95%CI [-0.47, 0.05], P =.11) or quality of life (SMD = 0.35, 95%CI [-0.20, 0.89], P = 0.21). Sensitivity analyses confirmed the robustness of the combined results.
Conclusions:
Though telemedicine can alleviate caregiving burden and anxiety of informal caregivers, it does not significantly reduce depression or improve the quality of life. Further high-quality, large-sample studies are required to validate the effects of telemedicine. Additionally, personalized intervention programs based on theoretical foundations are required to support caregivers. Clinical Trial: Registration number: CRD42023415688 (PROSPERO). https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=415688
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