Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 16, 2024
Date Accepted: Sep 4, 2024
Effectiveness of Internet-based telehealth program in patients with hip and/ or knee osteoarthritis: a systematic review and meta-analysis
ABSTRACT
Background:
Osteoarthritis (OA) is a chronic musculoskeletal disease that causes pain, functional disability, and economic burden. Non-pharmacological treatments are at the core of OA management. However, limited access to these services due to uneven regional local availability has been highlighted. Internet-based telehealth (IBTH) programs, provide digital access to abundant health resources, offering advantages such as convenience and low cost-effectiveness. These characteristics make them promising strategies for the management of patients with OA.
Objective:
To evaluate the effectiveness of the Internet-based telehealth program in the management of patients with hip and/or knee OA.
Methods:
Six electronic databases were systematically searched to identify trials comparing the IBTH program with conventional interventions for hip and/or knee OA. Studies were selected based on inclusion and exclusion criteria, focusing on outcomes related to pain, function, and self-efficacy. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to compare outcome measures. Heterogeneity was assessed using the I² and χ² tests. The methodological quality of selected studies and the quality of evidence were evaluated for included studies.
Results:
A total of nine studies with a moderate risk of bias were included in this meta-analysis. The pooled results showed that IBTH had a superior effect in relieving pain (SMD = -0.35 [95%CI = -0.45, -0.24], P < .001), increasing function (SMD = 0.29 [95%CI = 0.15, 0.43], P < .001), and improving self-efficacy for pain (SMD = 0.23 [95%CI = 0.10, 0.37], P < .001) compared with the conventional intervention group. Subgroup analysis revealed that IBTH with exercise could significantly alleviate pain and improve function and self-efficacy, but IBTH without exercise only had an effect on reducing pain.
Conclusions:
The meta-analysis provides moderate-quality evidence that the IBTH program has a beneficial effect on improving pain, function, and self-efficacy compared with conventional intervention in patients with hip and/or knee OA. Limited evidence suggests that the inclusion of exercise protocols in IBTH programs is recommended.
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