Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 3, 2023
Date Accepted: Feb 28, 2024
Effects of Telemedicine on Informal Caregivers of Palliative Care Patients: Systematic Review and Meta-analysis
ABSTRACT
Background:
Telemedicine technology is a rapidly developing field that demonstrates immense potential in improving medical services. In 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 and improve their health outcomes. However, research findings regarding the use of telemedicine among informal caregivers are controversial, and its efficacy remains unclear.
Objective:
This study aimed to evaluate the impacts of telemedicine on managing the burden, anxiety, depression, and quality of life of informal caregivers of palliative care.
Methods:
A systematic literature search was conducted using the PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL Plus with Full Text, CBM, CNKI, WanFang, and VIP databases to identify relevant randomized controlled trials (RCTs)published from inception to March 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. Intervention effects were estimated and sensitivity analysis was conducted using Review Manager 5.4, while 95% prediction intervals (PI) were calculated using R (version 4.3.2) and RStudio.
Results:
Nine RCTs were included in this study. The meta-analysis indicated that telemedicine has reduced the caregiving burden (SMD −0.49; 95% CI −0.72 to −0.27; P<.001; PI −0.86 to −0.13) and anxiety (SMD −0.23; 95% CI −0.40 to −0.06; P=.009; PI −0.98 to 0.39) of informal caregivers; however, it did not affect depression (SMD −0.21; 95% CI -0.47 to 0.05; P=.11; PI −0.94 to 0.51) or quality of life (SMD 0.35; 95% CI −0.20 to 0.89; P=.21; PI −2.15 to 2.85).
Conclusions:
While telemedicine can alleviate the caregiving burden and anxiety of informal caregivers, it does not significantly reduce depression or improve their quality of life. Further high-quality, large-sample studies are needed to validate the effects of telemedicine. Furthermore, personalized intervention programs based on theoretical foundations are required to support caregivers. Clinical Trial: PROSPERO CRD42023415688; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=415688
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