Impacts of Telehealth, Most Commonly-Used Telehealth Modalities Highlighted in Adolescents with Allergies

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This review of telehealth use among adolescents with allergic conditions synthesized evidence on patients’ transition to self-management of their conditions.

Mobile applications may be the most frequently utilized telehealth platform for adolescent patients with allergic conditions, according to a recent analysis, with positive effects seen in health and economic outcomes as well as patients’ self-management.1

These findings resulted from a systematic review of telehealth data on adolescent patients transitioning to self-management of their own allergic conditions. It was conducted given that adolescent individuals that have allergies have previously noted their own need for technological and online support in this transition.2

This new review into different studies surrounding this topic was led by Meg O' Sullivan, from the University of Cork and Cork University Hospital in Ireland.

“No previous reviews have been identified that are specific to this population but are broad in terms of the telehealth interventions examined,” O’Sullivan and colleagues wrote. “This systematic review aims to synthesize the literature on telehealth interventions for transition to self-management in adolescents with allergic conditions.”

Background and Findings

The investigators began their searches in February of 2023, using the databases CINAHL, Embase, PubMed, and PsychInfo and implementing specific phrases and words linked to 'self-management,' 'allergic conditions,' 'telehealth,' and 'adolescents.' The research team’s strategies were formed with the help of a health sciences librarian, and they were adapted for each of the databases.

The database searches limited the studies to ones written in the English language and aimed at the previous 5 years. They also manually searched reference lists of studies and relevant reviews that had been included.

The included in the study as subjects were adolescents in the age range of 11-17 that had allergic conditions, and the interventions looked at by the investigators had to be using self-management and be telehealth-delivered or transition-promoting interventions. All of the study designs were permitted, and Covidence software facilitated the team’s reviews, with duplicates being taken out.

The investigators had 2 designated reviewers independently work on screening the included articles, and they would resolve disagreements through the use of a third party. Methodological quality evaluations involved the use of the Mixed Methods Appraisal Tool (MMAT) in both qualitative and quantitative research.

Appraisal of quality was carried out by a single reviewer, then cross-checked by another reviewer, without exclusion based on a given study’s findings. The team’s extraction of data looked at study details, conditions, country, participants' demographic data, and numbers, along with items on the TIDieR checklist.

The research team made sure to consider stakeholder input, evidence base, and equality considerations. The outcomes looked at by the team were placed into categories on self-management, economic, health, and patients’ implementation outcomes, and the data extraction was then cross-checked.

Overall, there were 18 articles included and they covered 15 telehealth interventions. These articles were 86% focused upon adolescent patients with asthma as a condition. The major telehealth modalities identified included the use of mobile applications, conferencing through video, virtual reality, platforms based on the web, and artificial intelligence.

The investigators labeled the interventions as 5 unique content categories: psychosocial, behavioral, educational, monitoring, and healthcare navigational. Intervention strategies such as gamification, peer and/or healthcare professional interaction, and tailoring were suggested as a means for enhanced engagement.

The research team found that there were positive effects from the health interventions or no difference compared to active controls, and these were seen in self-management results such as knowledge, health results like life quality, and economic results such as healthcare use. They also found that the most frequently-seen implementation outcomes that had been observed as enhanced by the measures were appropriateness, acceptability, feasibility, and fidelity.

“Intervention characteristics and implementation information should be clearly reported in future studies to enable replication so others can benefit from their experience,” they wrote. “The use of existing measures of transition readiness and the development of adolescent-specific measures of self-management would also be beneficial in the evaluation of future interventions.”

References

  1. Sullivan MO', Curtin M, Flynn R, Cronin C, Mahony JO, Trujillo J. Telehealth interventions for transition to self-management in adolescents with allergic conditions: A systematic review. Allergy. 2023; 00: 1-23. doi:10.1111/all.15963.
  2. Ramsey RR, Carmody JK, Holbein CE, Guilbert TW, Hommel KA. Examination of the uses, needs, and preferences for health technology use in adolescents with asthma. J Asthma. 2019; 56(9): 964-972.
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