Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
The purpose of this study was to evaluate the current literature that exists for telehealth interventions for chronic disease self-management within the scope of OT. This scoping review will benefit the OT profession by furthering the body of evidence on telehealth self-management interventions while also promoting the continuation of research on telehealth to complement developing technologies and practices.
Primary Author and Speaker: Elizabeth B. Albritton
Additional Authors and Speakers: Josephine Fish, Jeffrey Henkel, Shelby Lee, Rachel Luttrell, and Rachel Rackleff
Contributing Authors: Pamalyn Kearney, Teal Benevides
PURPOSE: The purpose of this presentation is to describe a scoping review evaluating the current literature that exists for telehealth intervention for chronic disease self- management within the scope of occupational therapy. Chronic disease self-management is a major focus in healthcare, and increased attention has been focused on programs that help patients control symptoms to maintain independence and quality of life over longer periods of time (Grady & Gough, 2014). Our study addresses self-management as it relates to diseases such as diabetes, chronic lung disease, arthritis, cancer, heart disease, and chronic kidney disease. This presentation directly addresses the AOTA priority topic area of access to healthcare among those with chronic health conditions. The need to ensure occupational therapy practitioners provide care using evidence-based telehealth approaches for vulnerable populations has become especially critical due to COVID-19 pandemic shifts in delivery practices.
DESIGN: We utilized a scoping review design that followed the protocol developed by Arskey and O’Malley’s (2005) methodological framework.
METHOD: We searched PubMed, CINAHL, and Proquest using a specific search strategy based on our inclusion and exclusion criteria. We applied the following inclusion/exclusion criteria to articles in our review: adults over the age of 18 with at least one chronic disease, participating in either synchronous or asynchronous telehealth that allows for contact between a healthcare provider and patient, and intervention within the scope of OT. Characteristics of each included article’s characteristics were extracted to describe telehealth approaches and population addressed. We identified themes and inferences were made to apply them to current OT practice. We also describe gaps and disagreements within the evidence to ensure proper application for practitioners.
RESULTS: 48 studies were identified as meeting criteria. Preliminary results indicate that the majority of studies utilize phone and/or web based technology to provide self-management telehealth interventions. The focus of these interventions varied, but most focused on chronic disease and self-management education, medication adherence, diet, wellness behaviors, symptom monitoring, goal setting, and increasing physical activity. Outcomes that were most frequently measured were self-efficacy, depression symptoms, quality of life, health status, knowledge of chronic disease, purposeful participation, self-management, and weight and/or physical activity change. The data suggests significant improvement in knowledge of chronic disease, access to healthcare services, quality of life, and self-management self-efficacy between control and telehealth intervention groups when compared.
CONCLUSION: Our preliminary findings suggest that there is a sufficient number of published chronic disease self-management telehealth interventions to support effective delivery by OTs. These interventions focus on providing patients with resources to support patients in self-management behaviors based on their chronic disease.
IMPACT STATEMENT: Occupational therapists should be aware of, and incorporate, available telehealth self-management interventions for management of chronic diseases. Peer-reviewed evidence from our scoping review will be presented. This contributes to the body of research focused on AOTA’s priority areas while also providing information to support practitioners in understanding specific interventions that could be effectively delivered through telehealth during the COVID-19 pandemic.
References
Arskey, H. & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. https://doi.org/10.1080/1364557032000119616
Grady, P. A., & Gough, L. L. (2014). Self-management: A comprehensive approach to management of chronic conditions. American Journal of Public Health, 104(8), pp. e25–e31. https://doi.org/10.2105/ajph.2014.302041
