Análise da efetividade da intervenção via remota em pacientes com doenças crônicas: revisão sistemática e meta-análise

Abstract

Background: Technological advances have allowed the use of digital tools in remote care and the development of telemedicine to meet the clinical needs of people suffering from chronic diseases. Objective: The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of the influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases. Methods: The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, in volunteers of both sexes, that were rehabilitated and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (Risk of Bias) tool, for analysis of the strength of evidence, the GRADE method (Grading of Recommendations Assessment, Developing and Evaluation) was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager). Results: After the screening, 13 trials were eligible that compared telemedicine to usual care without face-to-face intervention, involving 1,469 participants. Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning (p=0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions (p=0.0004), -0.30 (-0.47, -0.14), while for quality of life, no significant difference was identified (p=0.90), 0.01 (-0.13, 0.14). Conclusion: Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.