Abstract: https://www.acpjournals.org/doi/10.7326/M22-0737
URL goes live when the embargo lifts
A rapid systematic review of published research found that when telehealth-delivered care was used to supplement or replace in-person maternal care services, clinical outcomes and patient satisfaction were similar, and sometimes better, compared to in-person care. The findings are published in Annals of Internal Medicine.
Access to high-quality maternal health care is associated with reduced maternal morbidity and mortality because it facilitates identification of conditions that increase the risk for poor outcomes and enables timely prevention or treatment. Maternal morbidity and mortality are unacceptably high in the United States and significant health disparities exist. The use of telehealth services to deliver maternal care is a possible strategy towards improving delivery of maternity care, increasing patient satisfaction, and reducing health disparities.
Researchers from Oregon Health & Science University conducted a rapid review of 28 RCTs and 14 observational studies of 44,894 women to determine the effectiveness and harms of telehealth strategies for maternal health care in response to the recent expansion of telehealth arising from the COVID-19 pandemic and produced an evidence map to display research gaps. Many of the telehealth strategies included in the review were studied to treat postpartum depression, monitor diabetes or hypertension during pregnancy, or as an alternative to general maternity care for low-risk pregnancies. The authors found that telehealth strategies resulted in mostly similar, or sometimes better, maternal clinical, obstetric, or patient-reported outcomes compared with in-person care. More specifically, they noted that telehealth may have a role as a supplement to usual care for postpartum depression, as telehealth interventions were more likely to improve mood symptoms in the short term compared to in-person care alone, although effects may not be sustained. According to the authors, maternity care is particularly ripe for innovation, given the limited evidence supporting traditional approaches to prenatal care that rely on multiple in-person visits. They add that their findings highlight an ongoing need to incorporate methods to evaluate and improve health equity, an important element lacking in these telehealth studies.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the corresponding author, Amy G. Cantor, MD, MPH, please contact please contact the OHSU newsroom at news@ohsu.edu.
