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Technical difficulties and preferences for in-person care may reduce patients’ acceptance of telehealth

Gorst SL, Armitage CJ, Brownsell S, et al.  Home telehealth uptake and continued use among heart failure and chronic obstructive pulmonary disease patients: A systematic review  Annals of Behavioural Medicine. 2014; (48): 323-336

Review question

What factors influence whether patients with heart failure or chronic obstructive pulmonary disease (COPD) accept and continue to use telehealth? 


The increasing incidence of heart failure and COPD places a substantial economic burden on healthcare systems, and patients experience significant impairments in physical and social functioning as well as lower quality of life.

Heart failure and COPD patients often seek care that results in frequent emergency room visits and lengthy hospital admissions, further exacerbating the associated healthcare costs.

Home telehealth involves the remote delivery of health-related services to patients in their homes via information and communication, which can be used to assist in monitoring and managing the patient’s conditions. However, it is unclear whether patients will accept and  use these  services.

How the review was done

A detailed search of several electronic databases for studies published up to 2013 was conducted. Studies that focused on interventions involving healthcare professionals using telephones to deliver healthcare information to heart failure or COPD patients in their homes (including residential care homes) were included.

A total of 824 studies were identified in searches, and 37 were included in the review after assessments for eligibility.

This review was funded by Assisted Living Innovation Platform.

What the researchers found

Patients refuse or abandon telehealth due to technical problems and preference for in-person care. As such, patients should have access to proper equipment and quick solutions for their technical difficulties.

To ensure the acceptance and sustained use of telehealth, healthcare professionals should inform their patients about its benefits, including quick access to healthcare, and improved self-care and knowledge.

Further research should investigate if patients refuse to participate in the studies or telehealth, and how clinical staff have an impact on the acceptance rate.


This review found that patients refuse or abandon telehealth because of technical difficulties and their preference for in-person care, suggesting that proper equipment and technical support should be more readily available. Healthcare professionals should attempt to inform patients of the benefits of telehealth, such as easy access to healthcare, and improved self-care and knowledge. Further evidence is required to explain the factors, including how the role of clinical staff affect a patient’s willingness to participate in telehealth.

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