Video Telehealth as Effective as Usual Care for Chronic Diseases

Video visits for chronic disease treatment are as safe and effective as in-person care, according to a new study.

The study, published in the Annals of Internal Medicine, aimed to assess the benefits and harms of video-based telemedicine for the treatment of chronic diseases. Researchers searched PubMed, EMBASE, Web of Science, and the Cochrane Library for randomized controlled trials published from Jan. 1, 2013, to March 3, 2021.

They found 20 studies that met the inclusion/exclusion criteria and were rated low risk of bias or some concerns of bias, said study author Jordan A. Albritton, PhD, research public health analyst at RTI International, in an email.

The majority of the included studies focused on management of chronic disease via video-based telemedicine. The most common conditions studied were diabetes, respiratory conditions like asthma or chronic obstructive pulmonary disease, pain-related disorders, and heart failure.  

Nine of 12 studies where video telehealth was used to replace usual care and five of eight studies where video telehealth was used to augment usual care found that patient outcomes between the intervention and control groups were similar.

The remaining six studies found one or more primary outcomes that favored the video telehealth group over the usual care group.

"The findings generally show that video telehealth results in outcomes that are just as good as, and in some cases, better than usual care," Albritton said.

Overall, the virtual care modality showed similar results for clinical effectiveness, healthcare use, patient satisfaction, and quality of life as usual care for the conditions studied, the researchers concluded.

The analysis does have several limitations, however. First, none of the studies evaluated the use of video telehealth for diagnosis or prevention of disease. Second, no studies evaluated the effect of video telehealth on health equity or disparities. And third, studies that focused on mental health, substance use disorders, maternal care, and weight management were excluded.

In general, researchers found the scientific literature in this arena lacking.  

"I was most surprised by the limited number of studies and conditions represented," Albritton said. "Our study provides an important summary of existing literature, but more work is needed."

The research work that currently exists shows that the use of telehealth in chronic disease care, including for HIV, cystic fibrosis, and borderline personality disorder, results in outcomes on par with usual care.

Further, using telehealth to care for children with chronic conditions is likely to reduce hospital and emergency department visits, improve patient outcomes, and decrease healthcare costs, a study published last year shows.

But, as telehealth becomes increasingly integrated into care delivery, providers must also consider ever-evolving patient preferences.

For example, a recent survey shows that though live video was the most-used telehealth modality in 2021, satisfaction levels with this type of visit fell. In 2020, 53 percent of Americans said they were more satisfied with live video than previous in-person interactions, but this figure dropped to 43 percent in 2021.

Simultaneously, satisfaction with live phone calls jumped from 30 percent in 2020 to 33 percent in 2021, while satisfaction with asynchronous telehealth services leveraging pictures and videos grew from 41 percent to 54 percent in the same period.