Telemedicine application in patient with Diabetes, Hypertension and Rheumatoid arthritis: A systematic review and meta-analysis

Abstract Background: Under the global epidemic condition，the telemedicine was widely used in the world, especially in the period of long-term care and treatment. The aim of study is to verify the effectiveness of telemedicine in the management of chronic disease by using scientific methods such as hypertension, diabetes, rheumatoid arthritis by using Meta-analysis and systematic review methods. The purpose of this study was to systematic review of the effect of telemedicine in chronic disease, so as to provide inspiration for chronic disease management in the future. Methods: Article searching were performed using Web of Science, PubMed, MEDLINE, EMBASE and other library or database to retrieve articles which published from database and library establishment to October 31 st , 2020. Literature quality assessment, systematic review and Meta-analysis were then performed. Results: 12 articles were included in the literature quality assessment (7 diabetes,3 hypertensions,2 rheumatoid arthritis), the article included in this study is of high quality. There are 7 articles included in the Meta-analysis, the result shows there have effect in glycosylated hemoglobin after 12 months of intervention (95%CI=-1.53, -0.16; Z=2.42; P=0.02), compare with 6 months (95%CI=-1.32, -0.01; Z=1.99; P=0.05). It also showed that there was no significant difference in fasting blood glucose after 6 months of intervention (95%CI=-1.19,0.21; Z=1.37; P=0.17). Both systolic blood pressure (95%CI=-12.79, -3.69; Z=3.55; P= 0.0004) and diastolic blood pressure (95%CI=-9.90, -0.43; Z=2.14; P= 0.03) showed statistically significant. Moreover, we also found positive influence of telemedicine about good behaviors and rehabilitation for rheumatoid arthritis patients. Conclusion: The results showed that telemedicine had a positive effect on the management of diabetes, hypertension and rheumatoid arthritis, especially on the management of glycosylated hemoglobin and blood pressure. Telemedicine technologies have great promotion to access the medical services and improve the quality of care, especially for people with chronic diseases .