The authors stated that 19 studies were included. However, a total of 26 reports of studies were presented in the tables. The studies appeared to include 7 randomised controlled trials described in 10 reports (n=546). Given the potential of overlapping samples it was not possible to be certain of these numerical values. The following reports were also included in the data extraction table: one pre-test post-test study (n=60), one 3-group case-control study (n=226), 3 observational studies (n=297 patients, n=5 nurses; and number of participants not reported), one of an intervention group only (n=14), 5 pilot studies although three could have been from the same study (n for each of 3 reports =11, n=90, n=31), one longitudinal prospective crossover study (n=28), one quasi-experimental study (n=212), one retrospective chart review (n=1,700 care episodes) and 2 descriptive qualitative studies (n=9 and number of participants not reported).
Effect on adult patients (7 studies).
Studies reported that telehomecare was associated with improvements in patient satisfaction, empowerment, remembering to prepare for the nurse’s visit and security, pain and anxiety. One study reported that patients felt greater understanding with in-person nurse visits than with telehealth consultations. One study reported greater confidence in managing health failure associated with telehealth care with or without nurses visits compared with telephone calls alone. The patients reported that the equipment was easy to use, increased their security, and was helpful in managing their condition in one study.
Chronic illness outcomes (11 studies).
Studies reported that telehomecare was associated with reductions in hospitalisation rates (8 studies in patients with heart failure, diabetes and spinal cord injury) and the ability to assess the progression of chronic wounds. Improvements were also reported in self-management, general health and rates of discharge to home with telecare when compared with usual care, and in function, activities of daily living and cognition in a group receiving telecare compared with matched controls. One study reported improvements over time in quality of life, function and depression associated with telecare; the authors stated that there were no between-group differences but no details of the control interventions were reported.
Providers (3 studies).
Studies on nurses reported that telecare was associated with the forging of new bonds with patients, and that patients had an improved focus and comfort with managing their condition. In addition, nurses reported its usefulness in monitoring vital signs, savings in time and increased productivity, and the ability to provide better patient care. In one study nurses felt that the technology could be frustrating and raise anxiety.