Specialist to non-specialist teleconsultation effective in managing Chronic Respiratory Diseases
A review suggests the use of specialist to non-specialist teleconsultation for diagnosis and management of Chronic Respiratory Diseases (CRDs) is encouraged.
A systematic review from RESPIRE researchers, published in the Journal of Global Health, found the available literature encouraged the use of specialist to non-specialist teleconsultation for diagnosis and management of Chronic Respiratory Diseases (CRDs).
The objective of the systematic review was to explore published evidence for the use of specialist to non-specialist teleconsultation in the management of CRDs in adults living in remote areas. Additionally, the team of researchers wanted to document the best practices and challenges, such as identifying knowledge gaps and providing recommendations for future research.
The study
The need for this study arose because CRDs are very common public health problems, which are often overlooked. For example, asthma is the 14th most important disorder in the world, in terms of disease burden, and chronic obstructive pulmonary disease (COPD) is the third leading cause of death, worldwide.
A key contributor to this burden and these deaths is the uneven distribution of the health workforce, creating a major barrier to their effective diagnosis and treatment. In the United States, less than one-third of the rural populations has access to a lung specialist within a ten-mile radius, and in India, there are only 2413 chest physicians for the total population of 1.3 billion people.
Tele-healthcare can bridge this distance barrier by facilitating greater access between specialist doctors and patient consultations, as well as their support to general physicians and specialised, local health workers.
By exploring evidence for the use of specialist to non-specialist teleconsultation in the management of CRDs in adults living in remote areas, its success for bridging the distance barrier can be evaluated.
Findings
The systematic review identified and analysed ten relevant papers that included all three parameters: teleconsultation, specialist to non-specialist consultation, and CRDs. From this, it was found that, despite the literature being limited and not generalisable, specialist to non-specialist teleconsultation for diagnosis and management of CRDs should be encouraged.
Therefore, the use of teleconsultation may potentially help patients for CRD diagnosis and management, where face-to-face consultations are not available. Consequently, tele-healthcare is a possible means of addressing the challenges related to uneven access to healthcare globally.
A limitation of this study could be the relatively few papers included. Future high-quality research conducted in controlled settings is needed to demonstrate how effective tele-healthcare could be in managing CRDs.
Rutuja Patil led this study. She is a RESPIRE PhD student based at Vadu Rural Health Program, KEMHRC Pune, India. She believes this publication could encourage the adoption of tele-healthcare for the management of CRDs, particularly with those in rural areas. She said:
During the COVID-19 global pandemic, we’ve seen the need for remote consultations in all areas of medicine, and in all settings. This systematic review has shown that teleconsultations can be used to diagnose and manage CRDs. We hope this will increase equity of access to healthcare for those who find it difficult to travel to see a specialist.
Read the paper
This publication is available from the Journal of Global Health.
Cite as
Patil R, Shrivastava R, Juvekar S, McKinstry B, Fairhurst K; for the RESPIRE collaboration: Specialist to non-specialist teleconsultations in chronic respiratory disease management: A systematic review. J Glob Health 2021;11:04019.