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Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review

Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review
Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review

Background: During the COVID-19 pandemic, telehealth was expanded without the opportunity to extensively evaluate the adopted technology’s usability. Objective: We aimed to synthesize evidence on health professionals’ perceptions regarding the usability of telehealth systems in the primary care of individuals with noncommunicable diseases (NCDs; hypertension and diabetes) from the COVID-19 pandemic onward. Methods: A systematic review was performed of clinical trials, prospective cohort studies, retrospective observational studies, and studies that used qualitative data collection and analysis methods published in English, Spanish, and Portuguese from March 2020 onward. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Studies involving health professionals who used telehealth systems in primary care and managed patients with NCDs from the COVID-19 pandemic onward were considered eligible. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles. The risk of bias and methodological quality of the included studies were analyzed. The primary outcome was the usability of telehealth systems, while the secondary outcomes were satisfaction and the contexts in which the telehealth system was used. Results: We included 11 of 417 retrieved studies, which had data from 248 health care professionals. These health care professionals were mostly doctors and nurses with prior experience in telehealth in high- and middle-income countries. Overall, 9 studies (82%) were qualitative studies and 2 (18%) were quasiexperimental or multisite trial studies. Moreover, 7 studies (64%) addressed diabetes, 1 (9%) addressed diabetes and hypertension, and 3 (27%) addressed chronic diseases. Most studies used a survey to assess usability. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems to be good and felt comfortable and satisfied. Patients felt satisfied using telehealth. The most important predictor for using digital health technologies was ease of use. The main barriers were technological challenges, connectivity issues, low computer literacy, inability to perform complete physical examination, and lack of training. Although the usability of telehealth systems was considered good, there is a need for research that investigates factors that may influence the perceptions of telehealth usability, such as differences between private and public services; differences in the level of experience of professionals, including professional experience and experience with digital tools; and differences in gender, age groups, occupations, and settings. Conclusions: The COVID-19 pandemic has generated incredible demand for virtual care. Professionals’ favorable perceptions of the usability of telehealth indicate that it can facilitate access to quality care. Although there are still challenges to telehealth, more than infrastructure challenges, the most reported challenges were related to empowering people for digital health.

COVID-19/epidemiology, Humans, Noncommunicable Diseases, Pandemics, Primary Health Care, Prospective Studies, Retrospective Studies, Systematic Reviews as Topic, Telemedicine/methods, COVID-19, COVID-19 pandemic, usability, telehealth, health care professional, noncommunicable disease
1438-8871
e44209
Gonçalves, Roberta Lins
39a8bbc8-de88-42ae-ab2d-08c7111a0722
Pagano, Adriana Silvina
f75b5c5b-9f49-4f04-be07-7680c117ea2d
Reis, Zilma Silveira Nogueira
173d08ff-a659-43a1-9d43-6fd9561ecbc9
Brackstone, Ken
33db3628-3171-4a7f-99cc-ad15db871fc5
Lopes, Taina Costa Pereira
076322a2-ed8a-425c-ad7b-61fe4e3ce82e
Cordeiro, Sarah Almeida
619a520b-b64c-4734-96f3-123d8f64d5b5
Nunes, Julia Macedo
4e531a5f-7d6d-47cc-b655-a786721f233b
Afagbedzi, Seth Kwaku
87cb1c33-7ca1-43e1-b0e9-e3e7d1afb8b7
Head, Michael
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Meira Junior, Wagner
aa32c2b6-aedc-453c-9911-3b20766a38f9
Batchelor, James
e53c36c7-aa7f-4fae-8113-30bfbb9b36ee
Ribeiro, Antônio Luiz Pinho
02fc542f-9149-4880-b2de-eae3637436f1
Gonçalves, Roberta Lins
39a8bbc8-de88-42ae-ab2d-08c7111a0722
Pagano, Adriana Silvina
f75b5c5b-9f49-4f04-be07-7680c117ea2d
Reis, Zilma Silveira Nogueira
173d08ff-a659-43a1-9d43-6fd9561ecbc9
Brackstone, Ken
33db3628-3171-4a7f-99cc-ad15db871fc5
Lopes, Taina Costa Pereira
076322a2-ed8a-425c-ad7b-61fe4e3ce82e
Cordeiro, Sarah Almeida
619a520b-b64c-4734-96f3-123d8f64d5b5
Nunes, Julia Macedo
4e531a5f-7d6d-47cc-b655-a786721f233b
Afagbedzi, Seth Kwaku
87cb1c33-7ca1-43e1-b0e9-e3e7d1afb8b7
Head, Michael
67ce0afc-2fc3-47f4-acf2-8794d27ce69c
Meira Junior, Wagner
aa32c2b6-aedc-453c-9911-3b20766a38f9
Batchelor, James
e53c36c7-aa7f-4fae-8113-30bfbb9b36ee
Ribeiro, Antônio Luiz Pinho
02fc542f-9149-4880-b2de-eae3637436f1

Gonçalves, Roberta Lins, Pagano, Adriana Silvina, Reis, Zilma Silveira Nogueira, Brackstone, Ken, Lopes, Taina Costa Pereira, Cordeiro, Sarah Almeida, Nunes, Julia Macedo, Afagbedzi, Seth Kwaku, Head, Michael, Meira Junior, Wagner, Batchelor, James and Ribeiro, Antônio Luiz Pinho (2023) Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review. Journal of Medical Internet Research, 25, e44209, [e44209]. (doi:10.2196/44209).

Record type: Article

Abstract

Background: During the COVID-19 pandemic, telehealth was expanded without the opportunity to extensively evaluate the adopted technology’s usability. Objective: We aimed to synthesize evidence on health professionals’ perceptions regarding the usability of telehealth systems in the primary care of individuals with noncommunicable diseases (NCDs; hypertension and diabetes) from the COVID-19 pandemic onward. Methods: A systematic review was performed of clinical trials, prospective cohort studies, retrospective observational studies, and studies that used qualitative data collection and analysis methods published in English, Spanish, and Portuguese from March 2020 onward. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Studies involving health professionals who used telehealth systems in primary care and managed patients with NCDs from the COVID-19 pandemic onward were considered eligible. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles. The risk of bias and methodological quality of the included studies were analyzed. The primary outcome was the usability of telehealth systems, while the secondary outcomes were satisfaction and the contexts in which the telehealth system was used. Results: We included 11 of 417 retrieved studies, which had data from 248 health care professionals. These health care professionals were mostly doctors and nurses with prior experience in telehealth in high- and middle-income countries. Overall, 9 studies (82%) were qualitative studies and 2 (18%) were quasiexperimental or multisite trial studies. Moreover, 7 studies (64%) addressed diabetes, 1 (9%) addressed diabetes and hypertension, and 3 (27%) addressed chronic diseases. Most studies used a survey to assess usability. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems to be good and felt comfortable and satisfied. Patients felt satisfied using telehealth. The most important predictor for using digital health technologies was ease of use. The main barriers were technological challenges, connectivity issues, low computer literacy, inability to perform complete physical examination, and lack of training. Although the usability of telehealth systems was considered good, there is a need for research that investigates factors that may influence the perceptions of telehealth usability, such as differences between private and public services; differences in the level of experience of professionals, including professional experience and experience with digital tools; and differences in gender, age groups, occupations, and settings. Conclusions: The COVID-19 pandemic has generated incredible demand for virtual care. Professionals’ favorable perceptions of the usability of telehealth indicate that it can facilitate access to quality care. Although there are still challenges to telehealth, more than infrastructure challenges, the most reported challenges were related to empowering people for digital health.

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More information

Published date: 16 March 2023
Additional Information: Funding Information: This research was funded by the Worldwide Universities Network (WUN RESEARCH PROJECTS), as part of the project “Leveraging digital healthcare experiences for post-pandemic non-communicable disease research - a multidisciplinary network engaging Brazil, Ghana, and the UK.” ALPR is supported in part by O Conselho Nacional de Desenvolvimento Científico e Tecnológico (465518/2014-1, 310790/2021-2, and 409604/2022-4), Universidade Federal de Minas Gerais, and Fundação de Amparo a Pesquisa do Estado de Minas Gerais (PPM-00428-17, RED-00081-16, and PPE-00030-21). Publisher Copyright: © Roberta Lins Gonçalves, Adriana Silvina Pagano, Zilma Silveira Nogueira Reis, Ken Brackstone, Tainá Costa Pereira Lopes, Sarah Almeida Cordeiro, Julia Macedo Nunes, Seth Kwaku Afagbedzi, Michael Head, Wagner Meira Jr, James Batchelor, Antônio Luiz Pinho Ribeiro.
Keywords: COVID-19/epidemiology, Humans, Noncommunicable Diseases, Pandemics, Primary Health Care, Prospective Studies, Retrospective Studies, Systematic Reviews as Topic, Telemedicine/methods, COVID-19, COVID-19 pandemic, usability, telehealth, health care professional, noncommunicable disease

Identifiers

Local EPrints ID: 475739
URI: http://eprints.soton.ac.uk/id/eprint/475739
ISSN: 1438-8871
PURE UUID: 6c2ff44d-974d-4ec4-9aa3-ded0eb0737c6
ORCID for Ken Brackstone: ORCID iD orcid.org/0000-0002-6882-3260
ORCID for Michael Head: ORCID iD orcid.org/0000-0003-1189-0531
ORCID for James Batchelor: ORCID iD orcid.org/0000-0002-5307-552X

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Date deposited: 27 Mar 2023 16:45
Last modified: 17 Mar 2024 03:37

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Contributors

Author: Roberta Lins Gonçalves
Author: Adriana Silvina Pagano
Author: Zilma Silveira Nogueira Reis
Author: Ken Brackstone ORCID iD
Author: Taina Costa Pereira Lopes
Author: Sarah Almeida Cordeiro
Author: Julia Macedo Nunes
Author: Seth Kwaku Afagbedzi
Author: Michael Head ORCID iD
Author: Wagner Meira Junior
Author: James Batchelor ORCID iD
Author: Antônio Luiz Pinho Ribeiro

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