TY  - JOUR
AU  - Wang, Hao-Nan
AU  - Luo, Pei
AU  - Liu, Shuyue
AU  - Liu, Yunyi
AU  - Zhang, Xiao
AU  - Li, Jian
PY  - 2024
DA  - 2024/9/30
TI  - Effectiveness of Internet-Based Telehealth Programs in Patients With Hip or Knee Osteoarthritis: Systematic Review and Meta-Analysis
JO  - J Med Internet Res
SP  - e55576
VL  - 26
KW  - osteoarthritis
KW  - knee
KW  - hip
KW  - telehealth
KW  - telemedicine
KW  - telerehabilitation
KW  - eHealth
KW  - exercise
KW  - PRISMA
AB  - Background: Osteoarthritis (OA) is a chronic musculoskeletal disease that causes pain, functional disability, and an economic burden. Nonpharmacological treatments are at the core of OA management. However, limited access to these services due to uneven regional local availability has been highlighted. Internet-based telehealth (IBTH) programs, providing digital access to abundant health care resources, offer advantages, such as convenience and cost-effectiveness. These characteristics make them promising strategies for the management of patients with OA. Objective: This study aimed to evaluate the effectiveness of IBTH programs in the management of patients with hip or knee OA. Methods: We systematically searched 6 electronic databases to identify trials comparing IBTH programs with conventional interventions for hip and knee OA. Studies were selected based on inclusion and exclusion criteria, focusing on outcomes related to function, pain, and self-efficacy. Standardized mean differences (SMDs) with 95% CIs were calculated to compare outcome measures. Heterogeneity was assessed using I² and χ² tests. The methodological quality of the selected studies and the quality of evidence were also evaluated. Results: A total of 21 studies with low-to-high risk of bias were included in this meta-analysis. The pooled results showed that IBTH has a superior effect on increasing function (SMD 0.30, 95% CI 0.23-0.37, P<.001), relieving pain (SMD –0.27, 95% CI –0.34 to –0.19, P<.001), and improving self-efficacy for pain (SMD 0.21, 95% CI 0.08-0.34, P<.001) compared to the conventional intervention group. Subgroup analysis revealed that IBTH with exercise can significantly alleviate pain and improve function and self-efficacy, but IBTH with cognitive-behavioral therapy only had the effect of reducing pain. Conclusions: The meta-analysis provides moderate-quality evidence that IBTH programs have a beneficial effect on improving function, relieving pain, and improving self-efficacy compared to conventional interventions in patients with hip or knee OA. Limited evidence suggests that the inclusion of exercise regimens in IBTH programs is recommended. Trial Registration: PROSPERO CRD42024541111; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=541111 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e55576
UR  - https://doi.org/10.2196/55576
DO  - 10.2196/55576
ID  - info:doi/10.2196/55576
ER  -