Nordheim LV, Haavind MT, Iversen MM, et al.
BMC health services research. Date of publication 2014 Nov 6;volume 14():565.
1. BMC Health Serv Res. 2014 Nov 6;14:565. doi: 10.1186/s12913-014-0565-6.
Effect of telemedicine follow-up care of leg and foot ulcers: a systematic
review.
Nordheim LV, Haavind MT, Iversen MM.
BACKGROUND: Leg ulcers and diabetes-related foot ulcers are frequent and costly
complications of their underlying diseases and thus represent a critical issue
for public health. Since the population is aging, the prevalence of these
conditions will probably increase considerably and require more resources.
Treatment of leg and foot ulcers often demands frequent contact with the health
care system, may pose great burden on the patient, and involves follow-up in both
primary and specialist care. Telemedicine provides potential for more effective
care management of leg and foot ulcers. The objective of this systematic review
of the literature was to assess the effect of telemedicine follow-up care on
clinical, behavioral or organizational outcomes among patients with leg and foot
ulcers.
METHODS: We searched Ovid MEDLINE (1980-), Ovid EMBASE (1980-), Clinical Trials
in the Cochrane Library (via Wiley), Ebsco CINAHL with Fulltext (1981-) and
SveMed + (1977-) up to May 2014 for relevant articles. We considered randomized
controlled trials, non-randomized trials, controlled before-after studies and
prospective cohort studies for inclusion and selected studies according to
predefined criteria. Three reviewers independently assessed the included studies
using the Cochrane Collaboration risk-of-bias tool. We performed a narrative
synthesis of results and assessed the strength of evidence for each outcome using
GRADE (grading of recommendations, assessment, development and evaluation).
RESULTS: Only one non-randomized study was included. The study (n = 140) measured
the effect of real-time interactive video consultation compared with face-to-face
follow-up on healing time, adjusted healing ratio and the number of ulcers at
12 weeks among patients with neuropathic forefoot ulcerations. There were no
statistically significant differences in results of the different outcomes
between patients receiving telemedicine and traditional follow-up. We assessed
the study to have a high risk of bias.
CONCLUSIONS: There is insufficient evidence available to unambiguously determine
whether telemedicine consultation of leg and foot ulcers is as effective as
traditional follow-up.
DOI: 10.1186/s12913-014-0565-6
PMCID: PMC4230629
PMID: 25373875 [Indexed for MEDLINE]
