A Systematic Review Identifying Adverse Health Outcomes and Mor tality Rates Associated with Telehealth

Background: The literature supporting telehealth management is growing, accelerated by the COVID pan-demic. We hypothesize that there are risks of adverse events associated with telehealth interventions. Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, ScienceDirect, and PsycINFO (January 1, 1960 to March 1, 2021) was conducted for all adverse events associated with telehealth. This systematic review and meta-analyses were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The systematic review included 78 studies, of which eight were included in the quantitative synthesis and two meta-analyses were conducted. Telehealth was associated with a 40% lower mortality risk among patients with heart failure compared to traditional care. Telemonitoring was also associated with a lower mortality risk compared to usual care, with a pooled relative risk of 0.60 (95% confidence interval [CI]: 0.43–0.84) in the random-effects meta-analysis. Among patients with heart implants, telemonitoring was associated with a 35% lower mortality risk compared to traditional care. Overall, telehealth was not associated with an increased number of adverse events compared to traditional healthcare methods in the randomized controlled trials included in the review. However, there remains a need for additional studies with consistent outcome assessments to complement the existing literature. Conclusions: While randomized clinical trials (RCTs) of telehealth interventions demonstrate enhanced patient outcomes in several studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggests an important need for more complementary studies with consistent outcome assessments.