Telemedicine in hemophilia: A comprehensive review

ABSTRACT

Background: Patients with hemophilia require regular assessments and physical examinations. The COVID-19 pandemic has resulted in the rapid adoption of telemedicine to enable virtual consultations and reduce hospital visits. However, the process of virtual consultations is new to many hemophilia clinics. A better understanding of best practices in telemedicine is important to ensure optimal quality of care for patients with hemophilia. Aims: To summarize the current literature on the use of direct-toconsumer telemedicine for patients with hemophilia and to describe the effectiveness and potential limitations of the technology and methods used. Methods: A comprehensive search was conducted in MEDLINE and EMBASE databases using the terms “hemophilia” AND “telemedicine” and their concept synonyms. There were no time or language restrictions. Title, abstracts, and full texts were screened. Included articles involved telemedicine interventions to facilitate clinical services directly between patients and providers without the use of third-party personnel. The primary outcome was the satisfaction of providers and patients. Secondary outcomes included economic considerations and clinical outcomes. Data were extracted based on study-specific, patient-specific, intervention-specific, and outcome-specific data. Results: Of the 925 articles screened, 6 articles were identified and summarized (Figure 1). Three articles described telemedicine within the context of COVID-19. Technologies used included telephone calls, videoconferencing, text messaging, and email. All studies involved a multidisciplinary team. Telemedicine in hemophilia care was found to positively impact the patient experience. Providers were satisfied with telemedicine. Telemedicine was economically beneficial and positively impacted patient outcomes. However, none of the articles reported on how telemedicine was specifically used to perform assessments during the virtual consultation process. Conclusions: The positive reception of telemedicine by patients and providers combined with the limited information available on methods of virtual assessments necessitates the development of a standard telemedicine guideline that can help providers learn how to best incorporate telemedicine to improve quality of care.