Telemedizin zur Unterstützung der Eltern von Hochrisiko‐Neugeborenen
Abstract
Background
Telemedicine is the use of electronic communications technology to provide care for patients when distance separates the practitioner and the patient. As the parents and families of infants admitted to the NICU require major support from health professionals in terms of information and time, telemedicine has the potential to increase this support.
Objectives
To evaluate if the use of telemedicine technology to support families of newborn infants receiving intensive care affects the length of hospital stay and parental/family satisfaction.
Search methods
We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2011, Issue 8), MEDLINE (from 1966 to September 2011), EMBASE (1980 to September 2011). We also searched ClinicalTrials.gov (http://www.clinicaltrials.gov) and the EudraCT (http://eudract.emea.eu.int) web sites. We searched the proceedings of conferences of the Canadian Society of Telehealth, American Telemedicine Association, the International Society for Telemedicine, the Annual Conference of The International e‐Health Association, American Medical Informatics Association and MedInfo.
Selection criteria
We attempted to identify randomised controlled trials that assessed the use of telemedicine designed to support parents of infants cared for in a Neonatal Intensive Care Unit (NICU) compared with standard support measures. Our primary outcome was the length of hospital stay, and secondary outcomes included parental and staff satisfaction, emergency hospital visits post‐discharge and family utilisation of infant health‐related resources.
Data collection and analysis
Two review authors independently screened the studies, extracted the data and assessed the risk of bias of the one included study using the standard methods of the Cochrane Neonatal Review Group. We planned to express treatment effects as risk ratio (RR), risk difference (RD), number needed to treat (NNT) and mean difference (MD) where appropriate, using a fixed‐effect model.
Main results
A single study was included for analysis in this review. This study compared the use of telemedicine (Baby Carelink) for parents and families of infants in the NICU with a control group without access to this programme and assessed the length of hospital stay for the infants and family satisfaction in multiple components of infant care. The study shows no difference in the length of hospital stay (average length of stay: telemedicine group: 68.5 days (standard deviation (SD) 28.3 days), control group: 70.6 days (SD 35.6 days), MD ‐2.10 days (95% confidence interval: ‐18.85 to 14.65 days). There was insufficient information for further analysis of measures of family satisfaction.
Authors' conclusions
There is insufficient evidence to support or refute the use of telemedicine technology to support the parents of high‐risk newborn infants receiving intensive care. Clinical trials are needed to assess the application of telemedicine to support parents and families of infants in NICU with length of hospital stay and their perception of NICU care as the major outcomes.
PICOs
Zusammenfassung in einfacher Sprache
Telemedizin zur Unterstützung der Eltern von Hochrisiko‐Neugeborenen
Die Telemedizin nutzt Informationstechnologien, damit Ärzte oder Pflegefachkräfte mit ihren Patienten kommunizieren können, wenn sie nicht im gleichen Raum sind. Die Eltern kranker Säuglinge, die auf neonatologischen Intensivstationen behandelt werden, benötigen viel Unterstützung, wenn es ihrem Kind schlecht geht und wenn sie ihr Kind mit nach Hause nehmen. Die Telemedizin kann Ärzten und Pflegefachkräften möglicherweise dabei helfen, die Bereitstellung von Unterstützung für die Eltern zu verbessern. In diesem Review wurde eine Studie ermittelt, deren Ergebnisse nicht zeigten, dass Telemedizin die Zeit, die diese Säuglinge im Krankenhaus verbringen, verändert. Allerdings waren die veröffentlichten Daten dieser Studie etwas ungenau, was es schwierig macht, Empfehlungen für oder gegen die Telemedizin zu auszusprechen.
