Telehealth Interventions Designed for Women: an Evidence Map

• Published in: Journal of general internal medicine : JGIM Vol. 33; no. 12; pp. 2191 - 2200
• Main Authors: Goldstein, Karen M., Zullig, Leah L., Dedert, Eric A., Alishahi Tabriz, Amir, Brearly, Timothy W., Raitz, Giselle, Sata, Suchita Shah, Whited, John D., Bosworth, Hayden B., Gordon, Adelaide M., Nagi, Avishek, Williams, John W., Gierisch, Jennifer M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2018; Springer Nature B.V
• Subjects: Breast cancer; Clinical trials; Disease control; Domestic violence; Evidence-Based Practice - methods; Evidence-Based Practice - standards; Family planning; Female; Gender; Health care; Health risks; Humans; Internal Medicine; Literature reviews; Medicine; Medicine & Public Health; Mental disorders; Mental health; Randomized Controlled Trials as Topic - methods; Randomized Controlled Trials as Topic - standards; Review Paper; Short message service; Systematic Reviews as Topic; Telemedicine; Telemedicine - methods; Telemedicine - standards; Violence; Women's Health - standards; Womens health; Effective Practice And Organisation Of Care (EPOC); Telehealth Modalities; Evidence Map; Intimate Partner Violence; Telehealth Interventions
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-018-4655-8

Background
Telehealth employs technology to connect patients to the right healthcare resources at the right time. Women are high utilizers of healthcare with gender-specific health issues that may benefit from the convenience and personalization of telehealth. Thus, we produced an evidence map describing the quantity, distribution, and characteristics of evidence assessing the effectiveness of telehealth services designed for women.
Methods
We searched MEDLINE
®
(via PubMed
®
) and Embase
®
from inception through March 20, 2018. We screened systematic reviews (SRs), randomized trials, and quasi-experimental studies using predetermined eligibility criteria. Articles meeting inclusion criteria were identified for data abstraction. To assess emerging trends, we also conducted a targeted search of
ClinicalTrials.gov
.
Results
Two hundred thirty-four primary studies and three SRs were eligible for abstraction. We grouped studies into focused areas of research: maternal health (
n
 = 96), prevention (
n
 = 46), disease management (
n
 = 63), family planning (
n
 = 9), high-risk breast cancer assessment (
n
 = 10), intimate partner violence (
n
 = 7), and mental health (
n
 = 3). Most interventions focused on phone as the primary telehealth modality and featured healthcare team-to-patient communication and were limited in duration (e.g., < 12 weeks). Few interventions were conducted with older women (≥ 60 years) or in racially/ethnically diverse populations. There are few SRs in this area and limited evidence regarding newer telehealth modalities such as mobile-based applications or short message service/texting. Targeted search of
clinical.trials.gov
yielded 73 ongoing studies that show a shift in the use of non-telephone modalities.
Discussion
Our systematic evidence map highlights gaps in the existing literature, such as a lack of studies in key women’s health areas (intimate partner violence, mental health), and a dearth of relevant SRs. With few existing SRs in this literature, there is an opportunity for examining effects, efficiency, and acceptability across studies to inform efforts at implementing telehealth for women.