JMIR Publications

ABSTRACT

Background:

Recurrent stroke is prevalent among stroke survivors. Telecare consultation has been suggested for the long-term provision of effective post-stroke management to stroke survivors due to the pandemic. However, its effectiveness in nurse-led post-acute stroke clinics among stroke survivors remains unclear.

Objective:

To evaluate the effectiveness of telecare consultation for post-stroke management among stroke survivors who are discharged from the hospital and live in the community.

Methods:

A literature search was conducted across six databases, including EBSCO, CINAHL, Google Scholar, MEDLINE, PsycInfo, and PubMed. Randomised control trials published from January 2015 to February 2025, examining the effectiveness of telecare consultations on post-stroke management among stroke survivors, were included. Continuous outcome data was calculated by using a mean difference or a standardised mean difference with a 95% confidence interval under the random-effects model, while dichotomous variables were calculated by using odds ratios with the 95% confidence interval, which were computed by Mantel-Haenszel’s methods. A standard χ2 test was used to evaluate the heterogeneity and significance of the results among studies.

Results:

Nine studies with a total of 2524 individuals were included in this review. Among all the participants, ischaemic stroke was the most common type of stroke (62.13%). The meta-analysis indicated that telecare has a statistically significant impact on meeting the target blood pressure (OR=2.33; 95% CI: 1.83 to 2.98; P<0.001; X2=5.99; I2=67%; P=0.05) and statistically significantly reduces the systolic blood pressure (SMD=4.37; 95% CI: 4.25 to 4.50; P<0.001; X2=527.71; I2=99%; P<0.001), diastolic blood pressure (SMD=3.79; 95% CI: 3.71 to 3.87; P<0.001; X2=140.13; I2=99%; P<0.001), and low-density lipoprotein-cholesterol (SMD=0.14; 95% CI: 0.14 to 0.15; P<0.001; X2=279.12; I2=100%; P<0.001) among the intervention group compared to the control group. Additionally, positive effects were found on coping and hospital readmission.

Conclusions:

Telecare consultation has significant impacts on blood pressure control, disease coping, and hospitalisation. However, its effects on psychological burdens and quality of life show controversial results. Additionally, non-significant effects on medication adherence and stroke recurrence were observed. It indicates that integrating telecare consultation into clinical practices potentially serves as an effective alternative for delivering post-stroke care; still, more studies are necessary to reinforce evidence in certain outcomes. Notably, the quality of studies was low, and most studies included short follow-up periods. Therefore, further research is needed to investigate the long-term impacts of telecare consultation. Clinical Trial: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023492692 on 25 December 2023.