Central Data Catalog

Background:
Chronic respiratory diseases (CRD), are common public health problems with high prevalence, disability and mortality rates worldwide. Further uneven distribution of the health workforce is a major barrier to the effective diagnosis and treatment of CRDs. Teleconsultation between a specialist and
non-specialist could possibly bridge the gap in access to health care and decrease
CRD burden in remote areas. This review investigates the evidence for the effective use of specialist to non-specialist teleconsultation in the management of CRDs
in remote areas and identifies instances of good practice and knowledge gaps.
Methods: We searched for articles till November 2020, which focused on specialist to non-specialist teleconsultations for CRD diagnosis or management. Two
independent reviewers conducted the title and abstract screening and extracted
data from the selected papers and the quality was assessed by Joanna Briggs Institute’s (JBI) tool. A descriptive and narrative approach was used due to the heterogeneous nature of the selected studies.
Results:
We found 1715, articles that met the initial search criteria, but after excluding duplicates and non-eligible articles, we included 10 research articles of
moderate quality. These articles were from nine different studies, all of which,
except one, were conducted in high-income countries. The studies reported results in terms of impact on the patients, and the health care providers including
primary care physicians (PCP) and specialists. The teleconsulting systems used
in all the selected papers primarily used audio modes in addition to other modes
like the audio-video medium. The included studies reported primarily non-clinical outcomes including effectiveness, feasibility, acceptability and usability of
the teleconsultation systems and only three described the clinical outcomes. The
teleconsultation was predominantly conducted in the PCP’s office with the specialist located remotely.
Conclusions:
We found relatively few, papers which explored specialist to
non-specialist teleconsultation in management of CRDs, and no controlled trials.
Two of the included papers described systems, which were used for other diseases in addition to the CRD. The available literature although not generalisable, encourages the use of specialist to non-specialist teleconsultation for diagnosis and
management of CRDs.