Telephone-Delivered Physiotherapy Interventions Improve Physical Function for Adults With a Chronic Condition: A Systematic Review and Meta-analysis

Maintaining the use of telehealth for delivering rehabilitation services in a regional hospital post-COVID19: Learning from telehealth delivery rates and staff experiences

ObjectiveTo examine what delivery format had been used to facilitate rehabilitation services over recent years and to identify barriers and enablers to using telehealth in the future.DesignMultiple method research approach.Setting: Outpatient rehabilitation service in a large regional hospital in Australia.Participants: Clinicians that deliver rehabilitation interventions including allied health professionals and nurses.Main measuresFirst, a retrospective audit of data examining the rate of telehealth use. Second, semi-structured focus groups with clinical staff to identify barriers and enablers to using telehealth. Data were thematically analysed and mapped to a behaviour change framework.ResultsPre-pandemic, 82% (n = 45,960) of rehabilitation services were delivered in-person; during peak restrictions, in-person delivery was 54% (n = 49,337). Following the ease of restrictions, 71% (n = 49,337) of the rehabilitation services were delivered in-person, 28% (n = 21,624) via phone and 1% (n = 493) via video. Telehealth use increased 11% from pre-pandemic to when restrictions were eased, driven by increased use of phone consultations. Six themes related to barriers and four themes related enablers to using telehealth were identified. Using the behaviour change framework, five interventions functions (education, training, environmental restructure, modelling and enablement) were recommended to facilitate telehealth use.ConclusionsTelehealth-delivered rehabilitation rates increased post-pandemic, primarily via phone consultations. Reported barriers and enablers highlight the need for targeted strategies, with five intervention functions identified that may support increased telehealth adoption in rehabilitation settings. Future efforts should address clinician-raised barriers to optimise telehealth integration into service delivery.

Telehealth-Delivered Allied Health Interventions: A Rapid Umbrella Review of Systematic Reviews

Introduction: Telehealth is used by allied health professionals to deliver health care remotely. This umbrella review addressed the following questions: (1) What telehealth interventions have been implemented to deliver allied health care? (2) What are the reported clinical benefits, and challenges of the implementation of telehealth delivered allied health interventions? (3) What are the reported experiences of patients and clinicians? Methods: A rapid umbrella systematic review method was utilized. Following a search of five electronic databases, only systematic reviews reporting on telehealth-delivery allied health interventions published in the past 10 years were included. Reported outcomes included clinical effectiveness, implementation factors, and patient/clinician experiences. Methodological quality was established using the A MeaSurement Tool to Assess systematic Reviews 2. Results: After applying eligibility criteria to 571 studies, 26 studies were included. Findings indicate that telehealth-delivered allied health interventions may obtain similar clinical outcomes as compared with face-to-face appointments. Patients reported less stress and valued the reduced need to travel when telehealth was used. Patient satisfaction with telehealth delivered care was equal to face-to-face care, and no differences were noted in the capacity to build therapeutic alliance when using telehealth. Difficulties with technology use were reported by clinicians and patients. Clinicians were identified as needing increased time management skills. Cautious interpretation of findings is recommended due to the quality rating of low to critical low for the majority of individual reviews. Conclusions: Telehealth-delivered care might obtain similar clinical outcomes to face-to-face care; however, difficulties may arise during broad implementation. It is recommended that health services be strategic to overcome implementation barriers and provide targeted support to enable effective, equitable, and sustained allied health service delivery via telehealth.