Emmanual Danso Gyakari, RN, DNP, CRNA

DNP Nurse Anesthesia 

Telehealth Effects on The Rural and Underserved Populations

Project Category: Evidence Synthesis 

Project Team: Emmanuel Danso Gyakari, DNP, CRNA, Kelsey O'Brien, DNP, CRNA, Lori Anderson, DNP, CRNA (Advisor)

Abstract

Background: Since the COVID-19 pandemic, access to telehealth has dramatically increased to reach patients while reducing the risk of exposure. However, no studies have directly reviewed the use of telehealth in the management of comorbidities and in improving the quality of care for underserved and rural populations. This integrative review aims to analyze the use of telehealth to provide better management opportunities for rural and underserved populations.

Methods: A systematic literature search was conducted through PubMed, CINAHL Complete, and Embase databases. Thirteen studies, including 11 randomized control trials (RCTs) and 2 non-randomized quasi-experimental studies, met inclusion criteria (n= 3,596 participants). The quality of each study was assessed using the JBI critical appraisal tools. The study findings were grouped into telehealth effectiveness on chronic management of diabetes (DM), hypertension (HTN), chronic obstructive pulmonary disease (COPD), and cancer on key disease-specific clinical outcomes.

Results: Telehealth interventions improved hemoglobin A1C, systolic blood pressure, admission rate, and quality of life among underserved and rural communities with DM, HTN, COPD, and cancer. Out of the 13 articles analyzed, 9 supported the use of telehealth in the rural/underserved population(s) for the optimization of comorbidities. 

Conclusion: The evidence shows that telehealth effectively optimizes comorbidities among rural and underserved populations and may improve access to health care. Future research should include other prevalent chronic illnesses and barriers to telehealth implementation. 

Full Manuscript