| Barlow 200720 | 98 studies (68 RCTs; 30 observational studies) | UK | Health status (blood glucose, blood pressure), quality of life, satisfaction, utilisation, other (safety and security monitoring), cost-effectiveness, education | Asthma, arthritis, CHD/CHF, chronic back pain, COPD, dementia, depression, diabetes (31%), frail elderly, hypertension, assorted diseases
Adults and elderly patients | Telecare at home including telephone support, internet and e-mail, telemonitoring of vital signs, text messaging | More evidence is needed |
| Botsis 200870 | 54 studies (47 RCTs or CCTs, 7 qualitative studies) | Europe | Health status, clinical, quality of life, satisfaction, utilisation | CHF, CHD, chronic wounds, diabetes, Alzheimer’s disease or cognitive impairment, mobility disabilities
Elderly patients | Home telecare: telehealth, video conferencing, virtual visits, telemonitoring of vital signs, teleconsultations including real-time monitoring and communication | Could not replace nurse home visits |
| Bowles 200717 | 19 studies including RCTs, CCTs, observational studies and qualitative studies | USA | Health status, quality of life, satisfaction, clinical, support, utilisation, behaviour change | COPD, cancer, anxiety, CHF, CHD, CVD, hypertension, stroke (CVA), spinal cord injury, chronic wounds, diabetes
Adults and elderly patient; focus on older adults | Telehomecare (by nurses): interactive visits, video visits, transmission of vital signs | Telehomecare is best for patients requiring close monitoring and quick interventions (i.e. HF patients) |
| Cole-Lewis 201071 | 17 papers representing 12 studies (9 RCTs, 2 cross-over studies, 1 quasi-experimental study) | USA | Health status, clinical, behaviour change | Asthma, diabetes, weight loss/prevention, medication adherence, physical activity, smoking cessation
All studies included adults; four targeted adolescents or young adults and one study included 10- to 19-year-olds | Text messaging (only component in five studies – others also used internet and e-mail) | Evidence of a short-term effect on behavioural or clinical outcomes. Text messaging useful in disease prevention and management interventions for weight loss, smoking cessation and diabetes. Effective for adolescents and adults, minority and non-minority populations and across nationalities |
| Cuijpers 200840 | 12 RCTs | Europe | Health status, quality of life | Migraine/recurrent headache, other problems, pain
Children, adults and elderly | Online CBT with a strong psychoeducational element. Control group – waiting list or self-help only | Effective for some conditions but unable to draw definite conclusions because of small numbers of studies. Very few studies compared the online intervention with face-to-face treatment. Unable to draw definite conclusions about whether or not CBT delivered through the internet was effective – more research on online CBT needed |
| Dellifraine 200816 | 29 studies (25 RCTs, 2 not randomised, 2 unable to tell) | USA | Health status, utilisation, clinical | Asthma, arthritis, anxiety, CHF, coronary artery bypass, COPD, depression, diabetes, hypertension, MS, multiple conditions, obesity, schizophrenia
Children, adults and elderly | Home telehealth: video monitoring, telephone, internet, vital signs transmission | Effective for some conditions but limited information about intervention characteristics |
| Garcia-Lizana 20078 | 24 RCTs | Europe | Health status, quality of life, satisfaction, clinical, support, utilisation, behaviour change, education | Asthma, CHF, CHD, CVD, diabetes, hypertension
Children and adults | Information and communication technologies including interactive computer games, telemonitoring of vital signs, internet and web-based interventions for disease management, telephone, videophone | Some positive utilisation and clinical outcomes. Benefits for controlling and managing chronic diseases were limited. No agreement on appropriate features of interventions. Limitations of studies – lack of high-quality evidence and data on the ability of information and communication technologies to increase knowledge and social support for people with chronic disease |
| Hersh 200672 | 106 studies including RCTs (class I), CCTs (class II), case series (class III), cohort studies (class III), case–control studies (class III). One-quarter met class I criteria and 28 studies were of home-based interventions | Canada | Health status, utilisation | Home-based interventions reported on only: asthma, CAD, CHF, chronic disease, diabetes, hypertension, lung transplant, MS, obesity, psychiatry, spinal cord injury
Mainly adult; one paediatric asthma study; four chronic disease in the elderly studies and one home-based study mentioning senior agencies. Two studies included veterans | Telemedicine: web-based monitoring, transtelephonic monitoring, telemonitoring, Health Buddy, remote monitoring, telemedicine, uploading electronic diary, video monitoring | Home-based services used to enhance the care of patients who already receive conventional services. Limitations of studies included small sample sizes and poor designs |
| Krishna 200973 | 20 RCTs, 5 CCTs | USA | Health status, quality of life, satisfaction, behaviour change, education | Asthma, diabetes, general outpatient, HIV and AIDS, health promotion, hepatitis vaccinations, hypertension, physical disabilities, smoking cessation, stress management
Adults and children | Health information delivered by mobile telephone or text messaging | 80% showed significant differences between intervention and controls |
| Murray 200511 (updated 2009) | 24 RCTs | UK | Health status, clinical, utilisation, cost-effectiveness, education, support, behaviour change, other | Asthma, diabetes, breast cancer or leukaemia, Alzheimer’s disease or memory loss, eating disorders, encopresis (faecal soiling – children), HIV and AIDS, obesity, urinary incontinence (women)
Children, adolescents and adults | Interactive Health Communication Applications (IHCAs) including computers, modems, telephone lines, internet and CD ROMs | Significant positive effects on knowledge, social support and behavioural and clinical outcomes. Not likely to have positive effects on overall self-efficacy. No evidence of effects on health service utilisation. Unable to determine effects on emotional or economic outcomes. Insufficient evidence to determine if ICHAs can benefit disadvantaged groups. Overall lack of high-quality evidence |
| Oake 200968 | 32 RCTs, 8 CCTs | Canada | Clinical, health status, quality of life, utilisation, satisfaction, behaviour change | Appointment reminders, asthma, chronic pain, cervical cancer screening, CHF, diabetes, dyslipidaemia, hypertension, immunisations, mental health, smoking cessation
Adults | Interactive voice response systems to contact patients at home with reminders or to track patient-assessed parameters at home | Caution against interpretation that technology improves outcomes as currently insufficient data |
| Paré 201069 | 62 studies (46 RCTs) | Canada | Health status, quality of life, utilisation, satisfaction | Asthma, CHF, diabetes, hypertension
Age not reported | Telemonitoring | Positive effects reported for diabetes, asthma and hypertension (associated with telemonitoring allowing for more frequent follow-up of patients). Failed to show a reduction in either mortality or hospitalisation rates for HF, although some trend towards shorter lengths of stay in hospital. Better glycaemic control and improved control of asthma and blood pressure. Larger trials are needed to confirm the benefits of this technology for these patients |
| Polisena 200974 | 22 studies (14 RCTs, 4 CCTs, 4 pre–post studies) | Canada | Cost-effectiveness (including one cost unit analysis) | Cancer, CHF, CHD, COPD, diabetes, stroke, wound care
Severe and moderate; adolescents and adults (one study looked at those aged > 65 years) | Telehealth, telemanagement, Health Buddy devices, transmission of vital signs information | Quality of the studies in terms of economic evaluation was poor. Studies heterogeneous so difficult to make an informed decision on resource allocation. Potential of telehealth to be cost saving but cannot be sure until higher-quality studies are conducted |
| Rains 200975 | 28 pre- and post-test studies | USA | Health status, quality of life, satisfaction, behaviour change | Back pain, breast cancer, chronic pain, chronic illness, CVD, depression, diabetes, eating disorders, heart transplant, HIV/AIDS, panic disorder, Parkinson’s disease, weight loss maintenance, smoking cessation
80% adult population (non-student), remainder students or adolescents (focused on eating disorders and depression) | Computer-mediated support groups (CMSGs) | Participation in a CMSG intervention was associated with perceptions of significantly improved social support, reduced levels of depression and increased quality of life and self-efficacy. These effects were observed across a variety of different health conditions |
| Stinson 200976 | 29 studies including 5 RCTs and 1 pilot RCT | Canada | Health status, quality of life, utilisation, satisfaction, behaviour change | Asthma (including persistent asthma), encopresis, obesity, recurrent headaches, traumatic brain injury
Children and adolescents only (five studies targeted youth and parents; several used youth and parent dyads) | Internet-based self-management including web-based interactive programmes, e-mail, telephone and e-mail support | Improvements in symptoms in four of the five health conditions. Limited evidence regarding impact on health-care utilisation, knowledge and quality of life outcomes. Unable to determine effectiveness of internet interventions for self-efficacy, social support and emotional well-being. No definite conclusions about whether or not self-management interventions delivered through the internet are as effective as face-to-face therapies as most of the studies used usual care or wait-list control comparison groups. Limited data in studies in the review |
| Tran 200877 | 78 studies (diabetes, chronic disease, COPD, CHF, diabetes, CHF, COPD, chronic disease | Canada | Health status, utilisation, cost-effectiveness, quality of life, satisfaction | CHF, chronic diseases, COPD, diabetes
Adults and older people (> 65 years) | Telehealth: telephone, videophone, telemonitoring, pager, mobile technology | Home telemonitoring and telephone support effective for improving glycaemic control for patients with diabetes and for reducing mortality rates among patients with HF. Higher mortality rate among patients with COPD using home telehealth interventions, but few studies and sample sizes small. Variability in the quality of studies – poor study designs or small sample sizes. Home telehealth generally clinically effective and no patient adverse events reported. Evidence on service utilisation is more limited but shows potential. Economic review – overall quality of the original research was low |
