Journal of the American College of Surgeons | 2021
Perioperative Telehealth Interventions in Geriatric Surgery_A Systematic Review
Abstract
Introduction: Telehealth has become mainstream during the COVID-19 pandemic, but its role in managing older patients is not well defined. This systematic review aims to assess the postoperative benefits of perioperative telehealth interventions in older adults. Methods: PubMed, Cochrane, and Embase databases were searched through October 2020. Two separate reviewers screened abstracts from the search. Studies were included in the final list if they measured outcomes of telehealth interventions in the perioperative period for patients > 65 years old. Disagreements were settled by a third reviewer, and results were compiled from the final list of articles. Due to heterogeneity, a meta-analysis was not pursued. Results: The search yielded a total of 770 abstracts. Five were included in the review, three randomized and two prospective pilot projects with a collective total of 395 patients. Four studies found that there was a postoperative benefit following perioperative telehealth interventions. Specifically, the interventions improved subjective perceptions of recovery and symptom severity. Though not statistically significant, patients in all included studies had improvements in physical functioning. There was a consistent pattern of steady improvement from baseline in all health areas in older patients. A notable limitation in one study was that participants experienced technical difficulties and required ongoing technical support. Conclusion: Perioperative telehealth interventions in older adults can lead to improved clinical outcomes, but existing data are limited. More studies are needed to evaluate the application of telehealth to older adults with frailty, whose ability to participate in the technology may be limited.