Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Telehealth Adoption Among Saudi Older Adults: A Qualitative Analysis of Utilization and Barriers

BACKGROUND/OBJECTIVES

The rapid adoption of telehealth services has been significantly accelerated by the need for accessible healthcare solutions, especially among older adults. However, the utilization of telehealth remains limited in many regions, including Saudi Arabia. This study aims to identify the barriers and facilitators influencing telehealth adoption among older adults in Riyadh.

METHODS

A qualitative phenomenological approach was employed, involving semi-structured interviews with 25 participants aged 60 and above. Thematic analysis was utilized to analyze the data, allowing for the identification of key themes related to participants' experiences with telehealth services.

RESULTS

Four main themes emerged from the analysis: access to technology and connectivity, attitudes toward telehealth, support systems, and institutional and policy factors. Participants reported challenges such as low digital literacy and unreliable Internet access, along with the need for trust in healthcare providers. Family support and the desire for training resources were highlighted as important facilitators of telehealth utilization.

CONCLUSIONS

The findings indicate that addressing barriers such as digital literacy and connectivity is crucial for enhancing telehealth utilization among older adults. Implementing strategies that promote education, strengthen support systems, and improve policy frameworks is essential for facilitating greater engagement with telehealth services in this demographic.

Applications and outcomes of implementing telemedicine for hypertension management in COVID-19 pandemic: A systematic review

INTRODUCTION

COVID-19 presented a significant challenge for patients with hypertension in terms of access to care. However, telemedicine offered the healthcare system opportunities that had previously been underutilized. Therefore, this study aims to systematically review the applications and outcomes of telemedicine for hypertension management during the COVID-19 pandemic.

METHOD

A structured search was conducted in accordance with PRISMA guidelines across multiple databases, including PubMed, Cochrane, Web of Science, and Scopus. The search was limited to studies published from December 2019 until May 2023, resulting in a total of 3727 studies. After quality appraisal using the CASP checklists version 2018, 29 articles were included in the final review. Data analysis was performed using thematic analysis.

RESULTS

Most of the studies reviewed had used the proprietary platforms (N = 14) and 11 studies had used public platforms such as social messengers or email. Also 9 studies relied on phone calls (N = 9) to record and transmit the clinical data. Some studies had applied two different approaches (proprietary/public platforms and phone). six articles (20.7%) focused only on hypertension control, while 23 articles (79.3%) examined hypertension as a comorbidity with other diseases. Also, the study identified 88 unique concepts, 15 initial themes, and six final themes for outcomes of using telemedicine for hypertension management during the COVID-19 pandemic. These themes include BP control, BP measurement and recording, medication management, mental health, care continuity and use and acceptance.

CONCLUSION

Telemedicine provides patients with hypertension with the opportunity to engage in medical consultations in a more convenient and comfortable manner, with the same validity as in-person visits. Telemedicine facilitates the creation of a connected network to support patients with high BP at any time and in any location. Limitations and issues may arise due to patients and healthcare staff's unfamiliarity with telemedicine. These issues can be resolved through the ongoing use and continuous feedback.

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

BACKGROUND

This study considers care management for older chronic patients during and after the COVID-19 pandemic.

AIMS

To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT).

MATERIAL AND METHODS

In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period.

RESULTS

The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22-2.72) and body mass index (OR = 1.75; 95% CI: 1.08-2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32-2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01-1.86).

CONCLUSIONS

Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol.