Telemedicine in haemophilia during COVID-19 and beyond: a comprehensive review

Casey L Li; Anthony KC Chan; Davide Matino; Mihir D Bhatt; Kay Decker; Karen Strike

doi:10.2478/jhp-2021-0011

Abstract

Abstract Introduction

Patients with haemophilia require regular assessments and physical examinations. The COVID-19 pandemic has resulted in the rapid adoption of telemedicine to enable virtual consultations and reduce hospital visits. However, the process of virtual consultations is new to many haemophilia clinics. A better understanding of best practices in telemedicine is important to ensure optimal quality of care for patients with haemophilia.

Objectives

To summarise the current literature on the use of direct-to-consumer telemedicine for patients with haemophilia and to describe the effectiveness and potential limitations of the technology and methods used.

Methods

A comprehensive search was conducted in MEDLINE and EMBASE databases using terms referring to the concepts “haemophilia” AND “telemedicine” and their synonyms. There were no time or language restrictions. Title, abstracts, and full texts were screened. Included articles involved telemedicine interventions to facilitate clinical services directly between patients and providers without the use of third-party personnel. The primary outcome was the satisfaction of providers and patients. Secondary outcomes included economic considerations and clinical outcomes. Information was extracted based on study-specific, patient-specific, intervention-specific, and outcome-specific data.

Results

Of the 925 articles screened, six were identified and summarised. Three described telemedicine within the context of COVID-19. Technologies used included telephone calls, videoconferencing, text messaging, and email. All studies involved a multidisciplinary team. Telemedicine in haemophilia care was found to positively impact the patient experience. Providers were satisfied with telemedicine. It was also suggested to be economically beneficial and positively impacted patient outcomes. However, none of the articles reported on how telemedicine was specifically used to perform assessments during the virtual consultation process.

Conclusions

There is preliminary evidence that telemedicine may be beneficial in haemophilia care. Overall, patients and providers reported high satisfaction with the usage of direct-to-consumer telemedicine. This positive reception warrants improvements in standardisation of reporting and quality of study design to better assess its clinical and economic impact. Developing a standard guideline for virtual consultations would support healthcare practitioners in how to best incorporate telemedicine to improve quality of care.

Article

View Full Article

References

1. Srivastava A, Santagostino E, Dougall A, Kitchen S, Sutherland M, Pipe SW, et al. WFH Guidelines for the Management of Hemophilia, 3rd edition. Haemophilia 2020; 26(S6): 1–158. doi: https://doi.org/10.1111/hae.14046.
2. Iorio A, Stonebraker JS, Chambost H, et al. Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries. Ann Intern Med 2019; 171(8): 540–6. doi: https://doi.org/10.7326/M19-1208.
3. Saxena K. Barriers and perceived limitations to early treatment of hemophilia. J Blood Med 2013; 4: 49–56. doi: https://doi.org/10.2147/JBM.S43734.
4. Davis P, Howard R, Brockway P. An evaluation of telehealth in the provision of rheumatologic consults to a remote area. J Rheumatol 2001; 28: 1910–3.
5. Pariser P, Pham T-NT, Brown JB, Stewart M, Charles J. Connecting people with multimorbidity to interprofessional teams using telemedicine. Ann Fam Med 2019; 17 (Suppl 1): S57–S62. doi: https://doi.org/10.1370/afm.2379.
6. Rosenfeld BA, Dorman T, Breslow MJ, et al. Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care. Crit Care Med 2000; 28(12): 3925–31. doi: https://doi.org/10.1097/00003246-200012000-00034.
7. Dorsey ER, Topol EJ. State of telehealth. N Engl J Med 2016; 375(2): 154–61. doi: https://doi.org/10.1056/NEJMra1601705.
8. Stenberg PL. Rural Individuals’ Telehealth Practices: An Overview. Economic Information Bulletin no. 199. US Department of Agriculture, Economic Research Service, November 2018. Available from https://www.ers.usda.gov/publications/pub-details/?pubid=90529 (accessed 26 August 2021).
9. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727–33. doi: https://doi.org/10.1056/NEJMoa2001017.
10. World Health Organization. COVID-19 – China. Disease outbreak news: Pneumonia of unknown cause – China. 5 January 2020. Available from https://www.who.int/emergencies/disease-outbreak-news/item/2020-DON229 (accessed 26 August 2021).
11. Weissman GE, Crane-Droesch A, Chivers C, et al. Locally informed simulation to predict hospital capacity needs during the COVID-19 pandemic. Ann Intern Med 2020: M20–1260. doi: https://doi.org/10.7326/M20-1260.
12. Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med 2018; 178(6): 745–6. doi: https://doi.org/10.1001/jamainternmed.2018.1314.
13. Jacobson K, Hooke MC. Telehealth videoconferencing for children with hemophilia and their families: a clinical project. J Pediatr Oncol Nurs 2016; 33(4): 282–8. doi: https://doi.org/10.1177/1043454215607340.
14. O’Donovan M, Buckley C, Benson J, et al. Telehealth for delivery of haemophilia comprehensive care during the COVID-19 pandemic. Haemophilia 2020; 26(6): 984–90. doi: https://doi.org/10.1111/hae.14156.
15. Ludikhuize L, Jansen ME, Hooimeijer HL, de Bont ESJM, Tamminga RYJ. Feasibility of video consultations in case of acute complications in children with haemophilia. Haemophilia 2016; 22(6): e567–e70. doi: https://doi.org/10.1111/hae.13109.
16. Mondorf W, Eichler H, Fischer R, et al. Smart Medication™, an electronic diary for surveillance of haemophilia home care and optimization of resource distribution. Hamostaseologie 2019; 39(04): 339–46. doi: https://doi.org/10.1055/s-0038-1675575.
17. Zhang A, Liu W, Poon M-C, et al. Management of haemophilia patients in the COVID-19 pandemic: Experience in Wuhan and Tianjin, two differently affected cities in China. Haemophilia 2020; 26(6): 1031–7. doi: https://doi.org/10.1111/hae.14108.
18. Álvarez-Román MT, De la Corte-Rodríguez H, Rodríguez-Merchán EC, et al. COVID-19 and telemedicine in haemophilia in a patient with severe haemophilia a and orthopaedic surgery. Haemophilia 2020 Nov 3. doi: https://doi.org/10.1111/hae.14087. [Epub ahead of print]
19. Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open 2017; 7(8): e016242. doi: https://doi.org/10/1136/bmjopen-2017-016242.
20. Kulkarni R. Use of telehealth in the delivery of comprehensive care for patients with haemophilia and other inherited bleeding disorders. Haemophilia 2018; 24(1): 33–42. doi: https://doi.org/10.1111/hae.13364.
21. Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: systematic literature review. J Med Internet Res 2020; 22(2): e16407. doi: https://doi.org/10.2196/16407.
22. Mateo F, Carrasco JJ, Aguilar-Rodríguez M, et al. Assessment of Kinect V2 for elbow range of motion estimation in people with haemophilia using an angle correction model. Haemophilia 2019; 25(3): e165–e73. doi: https://doi.org/10.1111/hae.13744.
23. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare 2018; 24(1): 4–12. doi: https://doi.org/10.1177/1357633X16674087.
24. Udsen FW, Hejlesen O, Ehlers LH. A systematic review of the cost and cost-effectiveness of telehealth for patients suffering from chronic obstructive pulmonary disease. J Telemed Telecare 2014; 20(4): 212–20. doi: https://doi.org/10.1177/1357633X14533896.
25. Dinesen B, Haesum LKE, Soerensen N, et al. Using preventive home monitoring to reduce hospital admission rates and reduce costs: a case study of telehealth among chronic obstructive pulmonary disease patients. J Telemed Telecare 2012; 18(4): 221–5. doi: https://doi.org/10.1258/jtt.2012.110704.
26. Gellis ZD, Kenaley B, McGinty J, Bardelli E, Davitt J, Ten Have T. Outcomes of a telehealth intervention for homebound older adults with heart or chronic respiratory failure: A randomized controlled trial. Gerontologist 2012; 52(4): 541–52. doi: https://doi.org/10.1093/geront/gnr134.
27. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097. doi: https://doi.org/10.1371/journal.pmed.10000097.

PDF Download

Download PDF

Open in full-page viewer

Authors

Casey L Li

Department of Paediatrics, McMaster University, Hamilton, ON, Canada ; Hamilton Niagara Regional Hemophilia Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
Anthony KC Chan
Davide Matino
Mihir D Bhatt

Department of Paediatrics, McMaster University, Hamilton, ON, Canada ; Hamilton Niagara Regional Hemophilia Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
Kay Decker
Karen Strike

christkl@mcmaster.ca