Impact of Telehealth on the Current and Future Practice of Lipidology: A Scoping Review

ABSTRACT

Lead Author's Financial Disclosures Nothing to disclose. Study Funding: None. Background/Synopsis Telehealth services have been implemented in many chronic conditions with the expectation to improve care for patients and has expanded greatly due to the COVID pandemic. Little is known about the impact that telehealth on the practice of lipidology. Objective/Purpose: To determine the current utilization of telehealth for lipid management and explore barriers and enablers to telehealth's future impact on the practice of lipidology. Methods: The PubMed database was searched from inception to June 25, 2021, to identify all relevant articles published utilizing telehealth for lipid management. This search returned 376 articles when using the following key words "lipids or cholesterol" and "telehealth". Articles were included at screening if they mentioned telehealth and lipids. The definition of telehealth was refined during full-text screening as a synchronous visit between a patient and a clinician that replaced an in-office appointment. All other types of telehealth were excluded including those that only implemented mobile health technologies, remote monitoring, or call backs for return of laboratory results. Additionally, articles had to measure lipid levels. Article findings were synthesized into one of the following categories 1) barriers to implementing and delivery of telemedicine visits, 2) facilitators to implementing and delivery of telemedicine visits, 3) clinician perspectives on telemedicine, or 4) mention future utility of telemedicine. Results: Of the 376 articles found, 128 s were included, and 79 articles were included after full text screening. The main reason for exclusion were not meeting the definition for telemedicine. Of the 81 articles, 18 were reviews, 31 were randomized clinical trials, 15 were pre-post evaluations, and 15 were categorized as other study designs. About half of the articles reported telehealth services for individuals with diabetes. Barriers reported include lack of evidence that supports telemedicine's impact or sustainability, technology cost, high appointment cancelation rates, and lack of reimbursement for clinicians. Enablers reported positive to no-negative impact on health outcomes, cost savings for health systems, and easier implementation of multidisciplinary approaches to care. Clinicians had mixed feelings on their ability to deliver clinical care, but report improved patient satisfaction. Future use of telemedicine included mentions of the need for new reimbursement structures, technology literacy programs, and revisions to current clinician licensing laws. Conclusions: Telemedicine use to provide care for individuals with lipid conditions has expanded during the COVID pandemic, but more research is needed to determine whether it is a sustainable model for lipid management.