Research: Changing standard maternal care with telehealth produces comparable outcomes

August 05, 2022

2 min learn

Disclosures:
Candor reviews receiving a PCORI award as assist for the research. Please see the research for all different authors’ related disclosures.


Sufferers who obtained maternal care via telehealth had comparable, and sometimes higher, outcomes than those that obtained in-person care solely, in line with a research revealed in Annals of Inner Drugs.

Maternal mortality, morbidity and close to misses “are unacceptably excessive” in the US, “regardless of exceedingly excessive prices,” Amy G. Cantor, MD, MPH, a household doctor who focuses on major care for girls on the Pacific Northwest Proof-based Observe Heart in Portland, Oregon, and colleagues wrote. The numbers solely worsened during the pandemic, with maternal mortality charges growing by 33%, and outcomes being worse for these in underrepresented populations.

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Telehealth-delivered care, whether or not changing or supplementing standard care, produce comparable outcomes as in-person care alone, in line with researchers. Supply: Adobe Inventory.

On condition that the sphere of maternity care is “ripe for innovation,” the researchers wrote that these findings recommend telehealth might be able to enhance practices and outcomes.

Cantor and colleagues performed a speedy evaluate of 28 randomized managed trials and 14 observational research together with 44,894 girls. They analyzed telehealth methods that had been used as alternate options to in-person visits for prenatal care, diabetes or hypertension monitoring throughout being pregnant and postpartum despair through the COVID-19 pandemic.

The evaluate addressed 4 key questions:

  • Do maternal telehealth methods produce comparable outcomes?
  • Do maternal telehealth methods produce equal entry to care or well being disparities?
  • What gaps exist in present analysis?
  • What are the harms of telehealth methods for maternal well being?

Total, telehealth methods resulted in comparable obstetric and affected person satisfaction outcomes as in-person care, in line with Cantor and colleagues. The researchers discovered that supplementing in-person care with telehealth led to comparable or higher psychological well being outcomes. As well as, utilizing telehealth to scale back in-person prenatal visits for low-risk pregnancies was related to comparable medical outcomes as in-person care and better affected person satisfaction.

Nevertheless, the researchers had been unable to research equal entry to care. Although few harms had been reported, most research didn’t assess well being disparities and “there was no proof to tell how outcomes differed” in underrepresented populations, Cantor and colleagues wrote.

Together with well being disparities, different medical areas that lack proof and current gaps in analysis embrace obstetric outcomes for gestational weight acquire, smoking cessation, gestational hypertension and prenatal psychological well being interventions. Extra gaps that “can be utilized by stakeholders to tell priorities for future analysis” encompass obstetric and utilization outcomes for breastfeeding and opposed results of telehealth interventions, the researchers wrote.

Cantor and colleagues moreover discovered that there was a distinction when it got here as to whether the interventions supplemented or changed standard care. Many of the research within the evaluate “evaluated bidirectional telehealth interventions that supplemented in-person care,” which resulted in principally comparable outcomes, the researchers wrote. Nevertheless, with methods that changed it totally, utilization of care was higher, they added.

In all, the research “suggests telehealth methods may assist obtain prenatal care objectives,” the researchers wrote.

“These findings additionally spotlight an ongoing want to include strategies to judge and enhance well being fairness, an vital aspect missing in these telehealth research,” they wrote. “Future analysis ought to concentrate on bigger research with broader inclusion standards, study results of telehealth interventions in rural populations, and consider outcomes primarily based on inhabitants traits to tell the impact of telehealth on well being disparities and well being fairness and potential harms of telehealth interventions.”

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