Remote monitoring for long-term physical health conditions: an evidence and gap map

Article history

The research reported in this issue of the journal was funded by the HSDR programme or one of its preceding programmes as project number NIHR135450. The contractual start date was in November 2021. The final report began editorial review in November 2022 and was accepted for publication in February 2023. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HSDR editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.

Copyright statement

Copyright © 2023 de Bell et al. This work was produced by de Bell et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/. For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited.

2023 de Bell et al.

The problem, condition or issue

Changing population demographics and rising rates of non-communicable diseases are placing new demands on the health and social care services. 1 It is estimated that one in seven people in the UK will be aged over 75 years by 2040. 1 Similar patterns are being seen worldwide; by 2050, the proportion of the population over the age of 60 years will double. 2 Owing both to the likelihood of developing chronic conditions with age and lifestyle factors (e.g. low rates of physical activity), there has been an increase in the number of people living with non-communicable diseases such as type 2 diabetes, chronic obstructive pulmonary disorder (COPD) and cardiovascular disease (CVD). 1,3 New models of care are needed to meet the challenges this situation creates for health and social care.

Technology offers opportunities for innovation in service provision that could be used to address some of these challenges. 1,4 This has been recognised in policy, with the World Health Organization (WHO) digital health strategy advocating the use of technology that ‘strengthens and scales up health promotion, disease prevention, diagnosis, management, rehabilitation and palliative care’. 5 Within the NHS England Long Term Plan, there are plans to invest in and increase the use of technology in the healthcare system. 6 This aim has been accelerated by the COVID-19 pandemic, which led to rapid adoption of technologies that enabled the remote provision of health services around the world, demonstrating the potential of technology. 7,8

How the intervention might work

Existing evidence

Background scoping searches of the literature found reviews on the effectiveness of remote monitoring, as well as factors that influence its acceptability for patients and providers and implementation by healthcare providers.

Why it is important to do this review?

During our initial scoping searches of the literature, we identified a large number of systematic reviews focusing on the effectiveness of remote monitoring, and the acceptability and implementation of these interventions. Remote monitoring is used for a range of health conditions, varying in everything from the aspect of health that is monitored to the application of the technology in the intervention. Understanding this evidence, recognising where evidence is concentrated and identifying where there are gaps is important to support evidence-informed policy, commissioning and provision. 30 Our conversations with relevant stakeholders’ contacts at NHS England’s NHS @home initiative indicated that knowledge of the breadth of evidence on remote monitoring would be most useful in supporting their work. Concentrations of evidence for certain health conditions or technologies could help inform the development of interventions and the delivery of existing programmes.

It is also important to understand the current evidence base to direct research. 30 Identifying topics which have been the focus of research prevents the duplication of effort, while knowledge of gaps – populations, interventions or outcomes where there are no systematic reviews – can prioritise areas for the future. Remote monitoring is an important topic for research, given ambitions for the use of technology in the health services and its potential to support adaptation to meet changing demands for health care. While COVID-19 has demonstrated how rapidly digital technology can be deployed, there are still many unknowns, with devices often developed by technology firms for the fitness market then adapted for other uses. 31

Defining evidence and gap maps

Evidence and gap maps (EGMs) collate the research on a particular topic, providing an overview by summarising key characteristics of existing studies. 32 They are produced using similar methods to other forms of evidence synthesis, such as systematic reviews. However, unlike systematic reviews, they do not synthesise the findings of research; instead, they allow users to identify and access the research evidence most relevant to their patient groups and intervention focus, or to see where evidence gaps exist. 30,32 To produce an EGM, studies are categorised according to key dimensions (e.g. aims, methods, type of intervention, type of condition). A ‘map’ is then created by visually representing the number of studies in particular combinations of categories (usually in a two-dimensional grid). 33

Below, we describe the steps taken to produce this EGM on the effectiveness, acceptability and implementation of remote monitoring for long-term health conditions, as specified in our protocol. 34

Inclusion criteria

Inclusion criteria for reviews in the map are summarised below and in Table 1, with further details provided in Appendix 1, Table 5. Some systematic reviews included studies that did not meet our criteria; for example, they evaluated other eHealth interventions or were conducted in high- and low-income countries, in addition to relevant primary studies. As specified in our protocol,34 we considered reviews eligible for inclusion if 75% or more of the included studies met our inclusion criteria. We did not check individual primary studies; our decisions were based on information reported in the review.

Following title and abstract screening and after establishing the volume and nature of the available evidence, we decided to limit inclusion to reviews published since January 2018 for several reasons, as detailed below and further in the section Departures from the protocol:

• To make the map more relevant to decision-makers. Remote monitoring technology is changing rapidly (e.g. use of smartphones) and older systematic reviews included studies evaluating technology that is out of date in terms of capability (e.g. unable to automatically transfer data), with associated implications for the generalisability of findings on acceptability and implementation.

• To include reviews containing studies from both before and after the COVID-19 pandemic, which led to the rapid uptake of remote monitoring technology.

• To reduce the number of papers that needed to be screened. Our title and abstract screening produced a large number of full-text articles (n = 829), the double-screening of which was beyond our capacity. We, therefore, decided to focus on the more recent and relevant portion of the identified papers.

Search methods and sources

Information specialists (NS and AB) developed the bibliographic database search strategies using MEDLINE (via Ovid) in consultation with the review team. The search strategy combined search terms for remote monitoring and evidence syntheses using both controlled vocabulary (e.g. MeSH in MEDLINE) and free-text search terms. Search terms were partly derived from the titles and abstracts of preidentified systematic reviews of remote monitoring and from initial scoping searches.

Search results were date limited to 2012. However, following title and abstract screening, a post hoc decision was made to further limit the inclusion to reviews published since January 2018 (see Inclusion criteria and Departures from the protocol for further details).

Screening and study selection

Data extraction and management

We imported records of the included reviews from the Endnote libraries used for screening into EPPI-Reviewer 4 (EPPI Centre, Social Science Research Unit, UCL Institute of Education, University of London, London, UK). A standardised data extraction coding form was then constructed in EPPI-Reviewer 4. The categories in this form are those from the framework detailed below in Developing the framework and can be found in Report Supplementary Material 1. The form was piloted by two reviewers (SDB and ZZ) on a sample of included reviews (n = 10) and discussed by the whole review team (SDB, ZZ, NS, AB, JTC, RA). Once revised to ensure that information provided in the reviews was being represented accurately by the categories in the form, data on each category were collected from all included full-text items. We defined items as a single review where they were based on the same searches; these could include multiple reports or publications. Data extraction was conducted by one reviewer (SDB or ZZ) and checked by a second reviewer (SDB or ZZ), with disagreements settled through discussion and, if necessary, the involvement of a third reviewer.

We did not check for duplication of primary studies between reviews. Besides being a difficult and time-consuming process, similar reviews often had a slightly different focus which means that even if most of the included studies overlapped, we still would have had to include the review to capture the breadth of evidence available.

Continuing reviews were grouped according to the patient population on which they focused. One reviewer (SDB) classified the continuing reviews and these classifications were then checked by a second reviewer (ZZ).

Developing the framework

The development of our framework was an iterative process. An initial framework was created using information from key literature (e.g. 9,15,21) identified during our initial scoping searches and by stakeholders at NHS @home. This was revised and refined following our first meeting with our patient and public involvement (PPI) group (as detailed in Public and patient involvement) and through discussion with stakeholders at NHS @home.

Categories were designed to describe the breadth of remote monitoring interventions and outcomes reported in the included reviews, as well as being accessible and easy to use in the interactive map. During data extraction, when information in the included reviews did not fit any categories in the framework, we renamed or adjusted the categories to ensure that all characteristics of the interventions and measured outcomes were included in the EGM. These adjustments were discussed and agreed upon in team meetings. Categories included in the framework are described briefly below, with details given in the data extraction form in Report Supplementary Material 1; full definitions are provided in the EGM glossary, which can be found in Report Supplementary Material 2.

Within the framework, we aimed to extract data on factors related to diversity and inclusion such as age and gender. A lack of consistent reporting meant that there was not enough information included in reviews on these factors to form categories in the framework.

Methods for mapping

The data on each review entered into EPPI-Reviewer 4 were visualised in an interactive map using EPPI-Mapper, version 1.2.5 (EPPI-Centre, UCL Social Research Institute, University College London, London, UK). Each record in the map contains one review and details the author, year of publication, title, journal and abstract, as well as giving the digital object identifier and a summary of basic information in the review; for example, the number of primary studies included in the review and the definition of remote monitoring used by the authors. Where we found publications that were based on the same searches, we treated these as a single review, providing the details of the additional publications at the end of the study abstract, together with a link to the relevant publication(s).

Quality assessment

An adapted version of AMSTAR 2 was used to assess the quality of reviews included in the map. Quality appraisal was performed by one reviewer (SDB or ZZ) and checked by a second (SDB or ZZ), with disagreements settled by discussion and, if required, a third reviewer.

External engagement

Engaging users in the process of evidence synthesis is important to ensure that that outputs produced meet their needs. 43

Departures from the protocol

Title and abstract screening resulted in a large number of studies (n = 829) which needed to be checked at full text. As a result, we decided to restrict our inclusion criteria and limit full-text screening to articles published from 2018 onwards. This was a pragmatic decision, based on the need to reduce the number of studies to screen, but was made following discussion with NHS @home to ensure the relevance of the EGM to stakeholders. Remote monitoring technology is changing rapidly, so the results and conclusions of older systematic reviews are less reliable as they contain more studies on out-of-date technology and do not include more recent primary research studies. Older systematic reviews may also have been duplicated by more recent systematic reviews. Finally, even though the COVID-19 pandemic has accelerated the uptake and experience of remote monitoring in many patient groups, we wanted to capture reviews containing evidence from both before and after February 2020.

Results of the search and reviews included in the evidence and gap map

Figure 1 provides an overview of the search and screening process. Bibliographic database searches retrieved 12,124 records; 11,256 additional records were then identified through citation chasing or as completed reviews identified from PROSPERO searches. After deduplication, 7063 records from database searches and 1022 records from other sources were double-screened at title and abstract. This resulted in 986 reports which were eligible to be assessed at full text, 639 of which were published from 2018 onwards. These 639 were screened at full text, resulting in 72 systematic reviews (reported in 73 publications) being included in the EGM. The number of primary studies included in the reviews ranged from 3 to 118, median 16 (interquartile range 10–27; Figure 2). We found 86 continuing reviews (see Appendix 3).

FIGURE 1.

Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram.

FIGURE 2.

Number of studies included in the reviews.

A list of studies excluded after screening at full text, along with reasons for exclusion, can be found in Report Supplementary Material 3. The primary reasons for exclusion were that the included interventions did not meet our definition of remote monitoring (n = 161) or that the study design did not fit our definition of a systematic review (n = 165).

Map of included reviews

The interactive EGM can be found at https://eppi.ioe.ac.uk/cms/Portals/35/Maps/ExeterNIHR/RemoteMonitoring.

An example of the EGM is shown in Figure 3. Intervention categories are displayed as rows, outcome categories as columns, and the number of tiles indicate the number of reviews found in the cell. Colour represents study quality (as assessed by AMSTAR 2): dark green tiles indicate high-quality reviews, blue indicates moderate quality reviews, yellow low-quality reviews and pink critically low quality. The map has been prepared to be colour-blind friendly by using a colour palette with suitable shades and levels of contrast. 44

FIGURE 3.

Evidence and gap map of included reviews, showing intervention categories as rows and outcome categories as columns (subcategories can be accessed in the interactive map) and study quality (green indicates high quality, blue moderate quality, yellow low quality and pink critically low quality).

Individual reviews may be included in more than one category in the EGM, as they measure multiple outcomes, or report on several different types of intervention. Both in the narrative synthesis and in the figures and tables, the number of reviews reported is the total number of reviews found in that category. The sum of reviews for a figure or table, or in a descriptive summary, may therefore be greater than the number of unique reviews included within the category.

Below, we report areas of evidence synthesis concentration and ‘gaps’ in the EGM. ‘Gaps’ may show that remote monitoring has not been implemented for a certain combination of characteristics/outcomes (i.e. an ‘implementation gap’), that it has been implemented but not evaluated (i.e. an ‘evidence gap’) or that it has been implemented and evaluated through primary research, but not yet included in a systematic review (i.e. an ‘apparent evidence gap’).

Populations and participants in included reviews

The included systematic reviews focused on patients, with all 72 reporting outcomes from patient populations. There were some reviews that also included data from carers (n = 3) and healthcare professionals (n = 5), but a gap was evident regarding reviews of these populations.

A range of health conditions were represented in the included reviews (Figure 4). There was a concentration of evidence synthesis concerning patients with CVD (n = 45), with diabetes (n = 25) and respiratory conditions (n = 23) being the next most studied populations. Reviews tended to concentrate on individual long-term conditions, with only three focusing on patients with multiple morbidities. ‘Gaps’ in secondary research were evident with respect to cancer survivors and patients with neurological conditions such as dementia (n = 3). Three reviews included primary studies on patient groups that were not clearly defined, referring to, for example, ‘general chronic conditions’, while seven reviews included studies on other conditions such as inflammatory bowel disease or thyroid disease.

FIGURE 4.

Number of included reviews reporting on each patient category. PAD, peripheral arterial disease.

We aimed to extract further data on patient populations (e.g. age, gender, health literacy and digital literacy), so that the map could represent the diversity of populations in which remote monitoring is implemented, as well as factors that might influence the effectiveness or acceptability of remote monitoring for specific populations. However, the inconsistent reporting of these characteristics within the included reviews meant that this was not possible and indicates an evidence ‘gap’.

Continuing reviews were classified according to their patient population of focus. Similar to reviews included in the EGM, CVD, diabetes and respiratory conditions are the most common patient populations (Table 4). However, a larger proportion of continuing reviews focus on neurological conditions than among the included reviews.

TABLE 4 - Number of continuing reviews (N = 86) focusing on different patient populations

Patients	Reviews (n)
Cardiovascular disease	36
Respiratory conditions	13
Not clearly defined/reported	11
Diabetes	10
Neurological conditions	8
Other	5
Kidney disease	3
Cancer survivors	0

Type of remote monitoring in included reviews

Remote monitoring was used to measure a range of indicators of health status in the included systematic reviews, with several areas of evidence synthesis concentration evident regarding the format and delivery of interventions.

In terms of the indicator(s) of health status measured by remote monitoring, blood pressure (n = 47) was the most commonly used by primary studies in the included reviews. There were also concentrations of evidence synthesis relating to other cardiovascular measures (e.g. heart rate, arrythmia, atrial fibrillation; n = 35) and oxygen-related measures (e.g. blood oxygen saturation or lung capacity; n = 30). Medication/treatment adherence (n = 25), blood glucose (n = 22) and physical activity (n = 20) were the next most measured aspects of health (Figure 5). In 44 reviews, other indicators of health were monitored (e.g. weight). While the majority of measures were objective, 27 reviews included studies in which the symptoms were measured, often subjectively; for example, through questions on mood.

FIGURE 5.

Number of included reviews reporting on each category of health status measured by remote monitoring.

Health status was measured using implantable (n = 17) or wearable devices (n = 20) in some primary studies in the included reviews, but there was a concentration of evidence synthesis regarding the use of ‘other’ devices (n = 48; Figure 6). These included spirometers, weighing scales and blood pressure monitors. There were 29 reviews containing studies that used symptom tracking – this is more than the 27 reviews including studies on the monitoring of symptoms as this category also included the use of logbooks to record health indicators such as levels of physical activity. Data were passed from these devices to a healthcare professional via an app, website, e-mail or patient portal in primary studies included in 58 reviews, with 46 containing studies in which data were passed on automatically (Figure 7). There were fewer reviews containing studies where short messaging services (SMS; n = 10) or face-to-face meetings (n = 1) were used to pass on data, although, as noted in the Discussion, this does not necessarily indicate a ‘gap’.

FIGURE 6.

Number of included reviews reporting on how health status is measured in remote monitoring interventions.

FIGURE 7.

Number of included reviews reporting on each category for the (a) method of passing on the data; and (b) for the method of feedback to patients.

The majority of reviews included primary studies in which patients were provided with feedback as a result of remote monitoring. The type of healthcare professional with whom patients had contact was often not clearly defined (n = 43); where the role was defined, nurses were most frequently involved (n = 41), followed by doctors (n = 36) and other healthcare professionals (n = 24), for example physiotherapists. A concentration of evidence synthesis was present on the use of telephone calls (n = 42) by healthcare professionals to provide feedback to patients, with apps, websites, e-mails or patient portals (n = 29), and videoconferencing (n = 27) being the next most used methods of providing feedback (see Figure 7). No significant gaps were seen in terms of other methods of feedback, with 22 reviews reporting on feedback provided by SMS and 23 on face-to-face feedback. In 26 reviews, abnormal readings from monitoring resulted in an alert being triggered, prompting action by healthcare professionals.

The content of feedback found most often in the included reviews was motivation or education (n = 33) and changes to treatment/medication (n = 28). There were fewer reviews containing studies in which patients were referred, for example, to the emergency department (n = 12) as a result of monitoring. Most reviews also contained studies in which the content of feedback was not clearly defined (n = 46).

Outcomes reported in included reviews

The EGM includes 61 reviews that reported on the effectiveness of remote monitoring and 24 concerning its acceptability or implementation. Corresponding to the proportion of reviews that reported on effectiveness, the most common type of synthesis was meta-analysis (n = 48). Any outcome relating to effectiveness, acceptability or implementation was included in the map. By outcome, we mean what the remote monitoring intervention was intending to influence. For some interventions, the health indicator that was measured as part of the intervention was the same as the outcome that the intervention intended to influence (e.g. measuring and aiming to improve blood glucose levels in patients with diabetes), whereas in others the indicators measured were different (e.g. measuring heart rate in patients with CVD with the aim of reducing hospitalisations).

We grouped these outcomes into six broad categories, containing subcategories for specific outcomes (Figure 8). Four of these broad categories: (1) physical health, (2) mental health and well-being, (3) health behaviours and self-regulation and (4) health service use, contained outcomes associated with effectiveness. We used one broad category for acceptability and implementation, and one for adherence and compliance, which contained subcategories for both effectiveness and acceptability outcomes.

FIGURE 8.

Number of included reviews reporting on each broad outcome category.

There was a concentration of evidence synthesis on physical health outcomes (n = 55). Mortality (n = 23) and glycaemic control (n = 16) were the most frequently described in the reviews. Similar numbers of systematic reviews reported outcomes such as blood pressure (n = 9), oxygen consumption (n = 8) and risk of adverse events such as stroke (n = 8). Fourteen reviews included ‘other’ physical health outcomes such as cholesterol levels or fatigue. While the focus of most remote monitoring interventions in the reviews was on measuring physical aspects of health, some reported the benefits of these interventions for mental health and well-being (n = 26). Outcomes related to anxiety/depression were reported in 13 reviews, while there was a concentration of evidence synthesis on quality-of-life outcomes, with 24 reviews reporting these outcomes.

Self-management or self-care (n = 14) was the main outcome reported for the broad category health behaviours and self-regulation (n = 18). There were few reviews that included studies on risk factors, for example low physical activity (n = 4) or self-efficacy (n = 5). Reviews containing information on the impact of remote monitoring on health service use (n = 29) tended to focus on hospitalisation (n = 29), with fewer focusing on emergency room visits (n = 16). There were several aspects of health service use for which we found no evidence of secondary research, such as primary care visits and staff time.

Regarding the acceptability and implementation of remote monitoring (n = 25), there was a concentration of evidence synthesis related to the acceptability and satisfaction (n = 24) of remote monitoring interventions. There was less secondary research reporting on usability (n = 7) and other implementation-related factors (n = 9). There were 11 reviews that included studies reporting on adherence and compliance with the intervention.

Certain outcomes had evidence synthesis concentrations for specific health conditions. For CVD, the most common condition in the EGM, 23 reviews reported on hospitalisation, 18 on mortality and 13 on quality of life, whereas only 2 reviews reported on self-efficacy. Blood glucose (n = 15) was reported as an outcome for the majority of reviews focusing on diabetes. Few reviews reported on other physical health-related indicators for patients with diabetes; further outcomes with greater evidence synthesis included acceptability and satisfaction (n = 11), self-management or self-care (n = 7) and quality of life (n = 6). Respiratory conditions had evidence synthesis concentrations for acceptability and satisfaction (n = 13), hospitalisation (n = 12) and quality of life (n = 10), with fewer reviews reporting on health behaviours and self-regulation.

Quality of included reviews

The critical appraisal tool for systematic reviews AMSTAR 2 was used to assess the quality of included reviews. The majority of reviews in the map were of low quality (n = 33). While few were rated as high quality (n = 5), 22 were found to be of moderate quality and 12 were of critically low quality (Figure 9). In 56% of included reviews, the reason they were rated of low quality was the lack of a protocol. The majority of reviews described reasons for heterogeneity (92%) and adequately assessed the risk of bias in quantitative comparative evaluations (86%). However, it was often unclear whether the risk of bias in other quantitative study designs or qualitative studies had been assessed adequately (70%). For many reviews, while their searches were adequate as they searched at least two databases and provided keywords/a search strategy, their search strategies were not rated as fully comprehensive (68%), as they did not search as extensively as possible, for example in the grey literature or the reference lists of included studies. In terms of non-critical domains, few reviews described the funding sources of studies (82%) or gave full details of excluded studies (71%) but most provided details on the population, intervention, comparator and outcome(s) of focus (96%) and used appropriate methods of synthesis (97%). Additional details can be found in Appendix 4, Table 8.

FIGURE 9.

Overview of quality of included reviews, by AMSTAR 2 item; **indicates critical domains used to determine overall quality. PICO, population, interventions, comparison type and outcomes.

Patterns of evidence synthesis concentration and gaps regarding outcome and intervention categories were similar to those reported above across low- and moderate-quality studies. Of the five high-quality reviews, two reported mortality and three acceptability and satisfaction. Of those rated of critically low quality, four reviews included blood glucose as an outcome and three contained acceptability or implementation outcomes. A greater proportion of reviews assessed as critically low reported on patients with diabetes (7 of 25 reviews) than any other patient population.

Summary of main results

This EGM contains systematic reviews of primary studies reporting the effectiveness, acceptability or implementation of remote monitoring interventions. Owing to our stakeholders’ priorities, we did not explicitly seek or summarise systematic reviews of relevant economic or cost-effectiveness evidence. We found a considerable volume of research, particularly relating to the effectiveness of remote monitoring. There were some clear areas of evidence synthesis concentration and apparent gaps in the evidence; these are discussed below.

Areas of evidence concentration

Evidence synthesis concentrations in the map indicate that reviews of remote monitoring interventions have focused on certain health conditions, particularly CVD, diabetes and respiratory conditions. Accordingly, certain types of remote monitoring interventions are more represented in the map. For example, those measuring aspects of health related to CVD, such as blood pressure and heart rate, or respiration-related indicators, such as blood oxygen. Understandably, reported outcomes also varied depending on the condition, with concentrations of evidence synthesis for blood glucose for diabetes, mortality for CVD and hospitalisations for both CVD and respiratory conditions. There were also evidence syntheses regarding quality of life as an outcome of remote monitoring for all three of the most common conditions in the EGM.

The map contains a considerable number of reviews on ‘other’ devices (e.g. blood pressure or blood glucose monitors), reflecting the variety of health indicators that were measured by remote monitoring interventions and the range of technologies available. There was a greater volume of synthesised research on interventions where data were passed on via app, website, e-mail or patient portal, or automatically, than methods such as telephone calls or SMS. This perhaps reflects the fact that remote monitoring is often a form of digital innovation, and that a key aim of these interventions is to improve the efficiency of health care,9,45 for example through reducing re-admissions. 21 There were further concentrations of evidence synthesis relating to feedback, with feedback being most likely to be provided via a telephone call, and from a nurse, if the healthcare professional involved was reported.

Areas of major gaps in the evidence map and confidence considerations

Fewer reviews were found on the acceptability and implementation of remote monitoring than its effectiveness. This is not necessarily a gap, as separate effectiveness reviews are often conducted for different outcomes, meaning that they are likely to outnumber reviews on implementation-related factors, which typically summarise a wider range of measures within a single review. However, there was a clear gap in reviews reporting on the acceptability of remote monitoring to carers and healthcare professionals, and on factors affecting implementation in specific health conditions.

Actual or apparent gaps in secondary research on outcomes related to the potential benefits of remote monitoring should be highlighted. Some of the benefits of remote monitoring to patients are thought to be as a result of improved knowledge and self-management of their condition;18 we found a relative lack of reviews focusing on these outcomes. It has been suggested that remote monitoring could improve efficiency in the healthcare system,10 but reviews of health service use tended to focus on hospitalisations. We did not find any reviews looking at the effectiveness of remote monitoring for outcomes such as reducing staff workload. A small number of reviews reported risk of adverse events targeted by the intervention (e.g. adverse cardiovascular events) or caused by the intervention (e.g. inappropriate shocks from implantable cardioverter defibrillators when used for monitoring patients with heart failure), but there were no reviews for other adverse events such as communication errors.

The reviews reported a wide range of outcomes, which reflect the diverse impact that remote monitoring can have on patients’ physical and mental health, and the healthcare system as a whole (e.g. resource use). Twenty-three reviews reported mortality and eight reported risk of adverse events (e.g. stroke or cardiovascular events). Many of the reported surrogate outcomes (e.g. blood pressure, cholesterol and HbA1c) are well-established predictors of ‘harder’ outcomes (e.g. mortality, stroke and myocardial infarction) and could be more feasible to use than ‘harder’ outcomes (e.g. in younger patients with diabetes). Also, the studies reported a wide range of outcomes, including the impact on patients’ mental health, well-being and self-efficacy, which are also important to patients. The map could be used to explore to what extent outcomes important to patients are reported in a specific area, but this question as a whole requires further investigation and is beyond the scope of the current project.

Certain patient populations were also under-represented in the map: there was a lack of evidence synthesis on cancer survivors, those with neurological conditions and for other conditions such as inflammatory bowel disease. It should be noted that these were identified as ‘gaps’ as we found some evidence synthesis for these conditions. As discussed below in Implications for research, there are chronic conditions for which we found no secondary research, which are therefore not represented in the map.

There were few reviews that included interventions where SMS or face-to-face contact was used as a method of passing on data resulting from remote monitoring. However, as discussed in Areas of evidence concentration, this does not necessarily indicate a gap in the evidence. There were also few reviews that included studies where patients were referred for further medical intervention as a result of remote monitoring. This may be a gap in primary or secondary research, as one purpose of remote monitoring is to identify and react to exacerbations in a patient’s condition. 46,47 However, few interventions aimed to identify and react to exacerbations so this may indicate an implementation gap.

We aimed to extract demographic data and factors such as health and digital literacy, which might influence the effectiveness of remote monitoring from included reviews. There was a gap regarding these factors, with a lack of consistent reporting in the reviews, and there is, therefore, an evidence synthesis gap relating to diversity and inclusion in remote monitoring interventions and their impact on health equity.

In general, there was a lack of high-quality reviews in the map. In terms of critical flaws, less than half of the reviews had a published protocol and were rated as having an adequate but not comprehensive search strategy or description of the included interventions. Most of the reviews used appropriate methods for quality appraisal, data synthesis and investigation of heterogeneity. This means that the results from the majority of the included reviews might be biased and should be interpreted with caution, even when the included primary studies are of high quality.

Implications for research

Funders of systematic reviews and review authors should try to address the following issues:

• lack of systematic reviews on remote monitoring in specific health conditions

• failure to adhere to best practice guidelines for conducting systematic reviews and meta-analyses

• failure to report (by review authors and/or authors of studies included in the reviews) essential information related to the intervention, participant characteristics or other aspects of study design.

Cardiovascular disease, diabetes and respiratory conditions such as COPD are among the most prevalent long-term conditions in the UK and worldwide,48,49 so the focus of research on these diseases is important. However, remote monitoring offers the potential to manage a range of health conditions and, while these conditions may affect smaller numbers of people, remote monitoring could offer them significant benefits. We found few systematic reviews on monitoring for neurological conditions, such as dementia, although there are several continuing reviews in this area and reviews that did not meet our inclusion criteria. As the number of older people living with dementia in the UK is predicted to increase by 80% from 2019 to 2040, and the cost of care is expected to be £94.1 billion by 2040,50 there is a particular need for evidence synthesis of research on remote monitoring in this patient population. Similarly, systematic reviews are needed on conditions where remote monitoring could increase quality of life, such as inflammatory bowel disease,51 epilepsy and allergies;48 these are either potential areas for further research or, if primary research exists, for evidence synthesis.

The fact that 33 (46%) of the 72 reviews included in the map were judged to be of low quality is of particular concern and casts doubt on the usability of the review results for decision-making. Researchers should consult guidance documents such as those produced by the Centre for Reviews and Dissemination52 and the Cochrane Collaboration53 when conducting further reviews, as well as referring to PRISMA when reporting reviews. 54 There was a lack of high-quality reviews found, with the absence of a prespecified review protocol being the most common reason for reviews being judged as low quality. Registering a protocol on a recognised database such as PROSPERO (Centre for Reviews and Dissemination, University of York) is an important step in the conduct of a review, avoiding duplication of reviews, providing an understanding of the methods applied and reducing the risk of bias in the review. 52

Fifty-one per cent of the included reviews failed to report essential information about the intervention, the participants or some other aspect of study design that could affect the interpretation of results. The effectiveness and acceptability of remote monitoring interventions could be affected by a wide range of participant characteristics, such as age, professional role, educational status, health and digital literacy. 55 Future reviews should report such information as fully as possible, and should signal gaps in the reporting of primary studies, to improve the existing evidence base and help determine the impact of remote monitoring on equity of access to services.

Given the complexity of remote monitoring, detailed description of the included interventions and their variation is essential for readers to make informed decisions about the applicability and reliability of results. Researchers may find the TIDier (template for intervention description and replication) checklist useful,56 which is specifically designed to improve the reporting of healthcare interventions and could be used in conjunction with other CONSORT tools.

Eighty-two per cent of the reviews failed to report information on the funding of the included studies. Reporting such information is important, as this is an area where technologies may be, and often are, commercially produced. In other areas where this is the case, such as drug trials, sources of funding are routinely reported.

Implications for practice and/or policy

The EGM contains concentrations of evidence synthesis on the effectiveness of remote monitoring that could be used to support the commissioning of remote monitoring interventions by healthcare providers. The COVID-19 pandemic resulted in a rapid shift to the use of remote monitoring and other technologies. 7,8 Although there has been a return to face-to-face provision for many services, the pandemic demonstrated both the potential of such technology and its wider acceptability. The NHS plans to increase the use of remote monitoring in the future,6 through initiatives such as NHS @home, which is developing home monitoring programmes for various conditions such as heart and lung disease. As can be seen in the increasing number of reviews per year in the map, and the continuing reviews noted in Appendix 3, further evidence synthesis is likely to be available to support the design and delivery of remote monitoring. That said, it is conceivable that evidence from studies conducted pre-COVID-19 might now be less applicable given the recent scale of uptake and levels of acceptability in some contexts. With the pace of developments in remote monitoring technologies and the post-pandemic shifts in the context of their use, there may be a case for conducting reviews exclusively of more recent studies. This evidence could assist in achieving goals regarding the use of digital technologies, such as those set out in the NHS Long Term Plan6 and the WHO Global Health Strategy. 5

Diabetes, cardiovascular and respiratory conditions are some of the most common long-term conditions in the UK. 48 As the greatest quantity of evidence syntheses in the EGM relates to these conditions, the map could be particularly beneficial in supporting the commissioning or delivery of remote monitoring for people with these conditions. The map also contains evidence syntheses on the measurement of different health indicators and the use of different types of device, with many then passing on that data using apps, websites or patient portals. Information on the effectiveness of these different intervention features could be used by those delivering remote monitoring to design interventions with the most suitable features for their target populations.

While the map focuses on patients with long-term physical health conditions, evidence in the included reviews could aid healthcare professionals in supporting multiple aspects of patient’s health. Having a long-term physical health condition can have implications for mental health,57 and there is evidence synthesis in the EGM on the impact of remote monitoring on the mental health of those with physical health conditions, particularly quality of life.

The apparent lack of secondary research on families and carers is a problem for the successful implementation of remote monitoring interventions, as these groups often have the main responsibility for monitoring. 55 While there were fewer reviews reporting on the acceptability or implementation of remote monitoring interventions than on their effectiveness, a number were found, including a realist review,24 which could be used by healthcare professionals to identify key factors to ensure the successful delivery of these interventions.

Limitations

This is a map of systematic reviews, not trials, which is a strength, as high-quality systematic reviews are usually regarded as better for aiding decision-making. However, only including reviews is also a limitation because we were only able to include evidence for remote monitoring interventions that have been included in a systematic review. While some gaps in the map may be implementation gaps or may indicate a lack of primary research, for others, evidence may be available that has not yet been reviewed. As we did not check for duplication between reviews, the EGM may also misrepresent the true volume of evidence within some categories in the map.

As an umbrella term, eHealth, and terms related to the delivery of health care using technology which fall under it, such as telemedicine, are not used consistently in the literature. 4 Whether they encompassed remote monitoring was dependent on how they were defined by the authors in individual reviews. This meant that, in order not to miss any relevant reviews, we had to search for all relevant terms, with the fact that our database searches found only around half of the potentially relevant studies perhaps reflecting the challenges created by these differences in definitions. As definitions were rarely evident in the abstract, this also resulted in a large volume of literature to screen at full text.

The volume of literature meant that we applied strict inclusion and exclusion criteria; as a result, some relevant evidence may have been excluded. Included reviews were published after 2018, so earlier reviews with relevant information, particularly regarding the implementation of remote monitoring, will have been excluded. However, there have been considerable advances in technology in recent years, including capabilities that aid the implementation of interventions such as passing data automatically from the device to a healthcare provider. These advances make the findings of older reviews less applicable; for example, older technology might need specialist installation and maintenance, whereas new devices can be used immediately, so the impact of these exclusions is not likely to be significant. We also made the decision to include reviews only when 75% or more of included studies met our inclusion criteria, to ensure most evidence in the EGM is of relevance to users. However, a different cut-off point would change the evidence contained in the map. Despite this comprehensive search, authors often failed to clearly report either their interpretation of remote monitoring or the details of the interventions included in the review. When little information was given, we were inclusive, meaning that some information in the map may relate to interventions that do not fit our definition of remote monitoring.

Last, owing to the priorities expressed by our stakeholders (effectiveness, acceptability and implementation), we did not seek to include reviews of economic or cost-effectiveness evidence relating to remote monitoring interventions in the EGM. Some would regard this as a significant limitation of the evidence that we have summarised, given the cost-saving intentions of some types of remote monitoring, and as systematic reviews of economic evaluations or cost-effectiveness studies have been conducted in conjunction with some of the reviews of effectiveness included in our EGM. This could be addressed if an update of this EGM is conducted in the future.

Equality, diversity and inclusion

As stated in the protocol for this EGM,34 we aimed to extract data on factors such as age and gender, which might relate to the effectiveness of remote monitoring, from the included systematic reviews. However, inconsistencies in the reporting of these variables between reviews meant that this was not possible. While many meta-analyses included in the EGM conducted subgroup analyses, these focused on condition or length/type of intervention rather than demographic factors. It has been noted that remote monitoring tends to focus on narrow patient populations, rather than considering how factors such as age, gender, ethnicity, income and the intersection of these identities might impact its success. 55 Additionally, health and digital literacy were noted as important by a number of reviews (e.g., refs. 55,58,59) and need further consideration in research.

Our team was small, making it difficult to ensure diversity across a range of groups; we also did not feel comfortable asking team members to disclose information on diversity unless they wished to share this information. However, we did recruit a PPI group with a range of conditions to inform the review, representing the experience of the varied application of remote monitoring. All team members had experience of producing evidence syntheses, including EGMs, and working with stakeholders and PPI groups to achieve this. The review offered opportunities for the development of skills, through sharing knowledge on the conduct of EGMs for team members who had less experience of producing this form of evidence synthesis and mentoring of junior members by team leads in project management.

Public and patient involvement and engagement

While the topic and focus of the EGM were determined by the policy customers at the start of the project, discussions with the PPI group provided context and developed our understanding of the topic as well as confirming its importance. The input of the group informed the categories included in the data extraction form and the design of the EGM, particularly in improving clarity for non-expert users. Overall, PPI was valuable in improving the EGM; the main difficulty we encountered was with the programme (EPPI-Mapper 4) used to develop the EGM, which meant it was not easy to share in its draft stages.

Contributions of authors

Siân de Bell (https://orcid.org/0000-0001-7356-3849) (Research Fellow) contributed to the development of the protocol, carried out screening, data extraction and quality appraisal, developed the interactive EGM, led PPI engagement, and led drafting of the final report.

Zhivko Zhelev (https://orcid.org/0000-0002-0106-2401) (Research Fellow) carried out screening, data extraction and quality appraisal, developed the interactive EGM, supported PPI engagement, drafted sections of the report and read, provided feedback on, edited and approved the final version of the report.

Naomi Shaw (https://orcid.org/0000-0001-7387-1809) (Information Specialist) contributed to the development of the protocol, designed and ran the search strategies, carried out citation chasing and managed the bibliographic libraries, drafted sections of the report and read, provided feedback on, edited and approved the final version of the report.

Alison Bethel (https://orcid.org/0000-0002-0963-9201) (Information Specialist) contributed to the development of the protocol, designed and ran the search strategies, carried out citation chasing and managed the bibliographic libraries, drafted sections of the report and read, provided feedback on, edited and approved the final version of the report.

Rob Anderson (https://orcid.org/0000-0002-3523-8559) (Professor of Health Services and Implementation Research) provided overall project management and contributed to the scoping process, refining of research questions and protocol, development of interactive EGM, and read, provided feedback on, edited and approved the final version of the report.

Jo Thompson Coon (https://orcid.org/0000-0002-5161-0234) (Professor of Evidence Synthesis and Health Policy) contributed to the scoping process, refining of research questions and protocol, development of interactive EGM, and read, provided feedback on, edited and approved the final version of the report.

Publications

The evidence and gap map is available at: https://eppi.ioe.ac.uk/cms/Portals/35/Maps/ExeterNIHR/RemoteMonitoring.

Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. Campbell System Rev 2022;18:e1264. https://doi.org/10.1002/cl2.1264

Ethics statement

This was an evidence review, based on published systematic reviews, so did not require ethical approval.

Data-sharing statement

This is an evidence synthesis study based on published systematic reviews. It did not generate new data. All data extracted from the reviews, together with links to each publication, can be found in the evidence and gap map, available at: https://eppi.ioe.ac.uk/cms/Portals/35/Maps/ExeterNIHR/RemoteMonitoring. Further information can be obtained from the corresponding author.

Information governance statement

This study did not involve primary research or therefore the handling of any personal information.

Department of Health and Social Care disclaimer

This report presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, Medical Research Council, Central Commissioning Facility, NIHR Evaluation, Trials and Studies Coordinating Centre, the HSDR programme or the Department of Health and Social Care.

Disclaimers

This report presents independent research funded by the National Institute for Health and Care Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care.

MEDLINE (Ovid; search date 24 March 2022)

Ovid MEDLINE ALL <1946 to March 22, 2022>

1. Remote Sensing Technology/ 3617

2. Telemetry/ 10077

3. Telemedicine/ 32700

4. monitor*.ti,ab.  900789

5. 3 and 4 [combined with monitor* as telemedicine/ concept much broader to include remote consultations etc]  4977

6. Monitoring, ambulatory/ 8593

7. Wearable electronic devices/ 5748

8. Fitness trackers/ 986

9. ((remote* or home* or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) adj5 monitor*).ti. 10564

10. ((remote* or home* or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) adj2 monitor*).ab. 21761

11. ((remote* or digital or home*) adj2 (sensor* or sensing or tracker or tracking)).ti,ab. 11072

12. (remote* adj2 (measurement* or supervision or surveillance)).ti,ab. 911

13. “distant patient monitoring”. ti,ab. 1

14. (biosensor* or biosensing).ti. 18621

15. ((body or motion or inertia* or wearable* or worn or activity or ingestible* or implant* or insertable or patch* or location* or GPS or global positioning or acceleromet* or gyroscop* or wireless or fitness) adj2 (sensor* or sensing or tracker* or tracking)).ti,ab. 23838

16. ((wearable* or sensing) adj2 (device* or system* or technolog*)).ti,ab. 18640

17. (virtual adj2 (ward* or healthcare or “health care” or hospital* or monitor*)).ti,ab. 474

18. telemonitoring.ti,ab. 1805

19. ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health*) adj8 monitor*).ti,ab. 3017

20. (assistive technolog* adj5 monitor*).ti,ab. 17

21. (smart home* adj5 monitor*).ti,ab. 74

22. (smart house* adj5 monitor*).ti,ab. 2

23. (home automation adj5 monitor*).ti,ab. 9

24. (“Internet of things” adj5 monitor*).ti,ab. 155

25. (gerontechnolog* adj5 monitor*).ti,ab. 1

26. “electronic patient reported outcome”.ti,ab. 173

27. (ePROM or ePROMs or ePRO or ePROs).ti,ab. 274

28. 1 or 2 13626

29. or/5-27 108332

30. 28 or 29 117401

31. (metaanalysis or meta-analysis or metasynthesis or meta-synthesis).ti,ab. 198936

32. (systematic adj (review or overview or search*)).ti,ab. 228569

33. (systematically adj (review* or search*)).ab. 30524

34. evidence synthesis.ti,ab. 5678

35. thematic synthesis.ti,ab. 1109

36. (evidence adj2 map*).ti,ab. 1170

37. ((scoping or rapid or realist or mapping or umbrella) adj2 review).ti,ab. 16692

38. (qualitative adj2 synthesis).ti,ab. 3925

39. ((mixed-stud* or (mixed adj stud*) or (mixed adj method*) or mixed-method*) adj2 review).ti,ab. 836

40. cochrane.jw. 15903

41. systematic reviews.jn. 2245

42. systematic review/ 189020

43. “review of reviews”.ti,ab. 711

44. or/31-43 374135

45. 30 and 44 1768

46. limit 45 to yr=“2012 -Current” 1603

Embase (Ovid; search date: 24 March 2022)

Embase <1974 to 2022 March 23>

1. Remote Sensing/ [not exploded as satellite imagery is narrower term] 11917

2. Telemetry/ 19178

3. telephone telemetry/ 474

4. exp biotelemetry device/ [includes telemetric capsule, implant, electrocardiogam] 2001

5. telemonitoring/ 4378

6. exp telehealth/ 68732

7. monitor*.ti,ab. 1237541

8. 6 and 7 [combined with monitor* as telehealth/ concept much broader to include remote etc] 9619

9. ambulatory monitoring/ 12001

10. exp wearable computer/ [narrower terms include smartwatch and activity tracker] 6151

11. wearable sensor/ 1070

12. ((remote* or home or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) adj5 monitor*).ti. 14606

13. ((remote* or home or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) adj2 monitor*).ab. 32169

14. (home* adj5 monitor*).ti. 2974

15. (home* adj2 monitor*).ab. 5612

16. ((remote* or digital or home*) adj2 (sensor* or sensing or tracker* or tracking)).ti,ab. 10448

17. (remote* adj2 (measurement or supervision or surveillance)).ti,ab. 698

18. “distant patient monitoring”.ti,ab. 1

19. (biosensor* or biosensing).ti. 19868

20. ((body or motion or inertia* or wearable* or worn or activity or ingestible* or implant* or insertable or patch* or location* or GPS or global positioning or acceleromet* or gyroscop* or wireless or fitness) adj2 (sensor* or sensing or tracker* or tracking)).ti,ab. 27879

21. (virtual adj2 (ward* or healthcare or “health care” or hospital* or monitor*)).ti,ab. 670

22. telemonitoring.ti,ab. 2720

23. ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health*) adj8 monitor*).ti,ab. 4680

24. (assistive technolog* adj5 monitor*).ti,ab. 22

25. (smart home* adj5 monitor*).ti,ab. 74

26. (smart house* adj5 monitor*).ti,ab. 2

27. (home automation adj5 monitor*).ti,ab. 7

28. (“Internet of things” adj5 monitor*).ti,ab. 152

29. (gerontechnolog* adj5 monitor*).ti,ab. 1

30. “electronic patient reported outcome”.ti,ab. 305

31. (ePROM or ePROMs or ePRO or ePROs).ti,ab. 720

32. or/1-5 37406

33. or/8-31 120065

34. 32 or 33 142626

35. (metaanalysis or meta-analysis or metasynthesis or meta-synthesis).ti,ab. 256658

36. (systematic adj (review or overview or search*)).ti,ab. 278501

37. (systematically adj (review* or search*)).ab. 37779

38. evidence synthesis.ti,ab. 6270

39. thematic synthesis.ti,ab. 1252

40. (evidence adj2 map*).ti,ab. 1277

41. ((scoping or rapid or realist or mapping or umbrella) adj2 review).ti,ab. 17807

42. (qualitative adj2 synthesis).ti,ab. 4418

43. ((mixed-stud* or (mixed adj stud*) or (mixed adj method*) or mixed-method*) adj2 review).ti,ab. 890

44. cochrane.jw. 23690

45. systematic reviews.jn. 2268

46. “systematic review”/ 337681

47. exp meta-analysis/ 241798

48. “review of reviews”.ti,ab. 818

49. or/35-48 578110

50. 34 and 49 2743

CINAHL Complete (EBSCO; search date 24 March 2022)

1. S45 S29 AND S43 Limiters – Published Date: from 20120101 onwards (1117)

2. S44 S29 AND S43 (1281)

3. S43 S30 OR S31 OR S32 OR S33 OR S34 OR S35 OR S36 OR S37 OR S38 OR S39 OR S40 OR S41 OR S42 (220,592)

4. S42 TI “review of reviews” OR AB “review of reviews” (343)

5. S41 (MH “Meta Analysis”) (61,283)

6. S40 (MH “Systematic Review”) OR (MH “Scoping Review”) (111,189)

7. S39 JN systematic reviews (220)

8. S38 AB (((mixed-stud*) or (mixed N0 stud*) or (mixed N0 method*) or (mixed-method*)) N2 review) OR TI (((mixed-stud*) or (mixed N0 stud*) or (mixed N0 method*) or (mixed-method*)) N2 review) (666)

9. S37 AB qualitative N2 synthesis OR TI qualitative N2 synthesis (2438)

10. S36 AB ((scoping or rapid or realist or mapping or umbrella) N2 review) OR TI ((scoping or rapid or realist or mapping or umbrella) N2 review) (9786)

11. S35 AB evidence N2 map* OR TI evidence N2 map* (590)

12. S34 AB thematic synthesis OR TI thematic synthesis (926)

13. S33 AB evidence synthesis OR TI evidence synthesis (3539)

14. S32 AB systematically N1 (review* or search*) (13,064)

15. S31 TI (systematic N1 (review or overview or search*)) OR AB (systematic N1 (review or overview or search*)) (132,543)

16. S30 TI (metaanalysis or meta-analysis or metasynthesis or meta-synthesis) OR AB (metaanalysis or meta-analysis or metasynthesis or meta-synthesis) (92,251)

17. S29 S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR S25 OR S26 OR S27 OR S28 (35,725)

18. S28 AB (ePROM or ePROMS or ePRO or ePROs) OR TI (ePROM or ePROMS or ePRO or ePROs) (123)

19. S27 AB electronic patient reported outcome* OR TI electronic patient reported outcome* (258)

20. S26 AB (gerontechnolog*) N5 monitor* OR TI (gerontechnolog*) N5 monitor* (3)

21. S25 AB (“internet of things”) N5 monitor* OR TI (“internet of things”) N5 monitor* (32)

22. S24 AB (home automation) N5 monitor* OR TI (home automation) N5 monitor* (2)

23. S23 AB (smart house*) N5 monitor* OR TI (smart house*) N5 monitor* (1163)

24. S22 AB (smart home*) N5 monitor* OR TI (smart home*) N5 monitor* (21)

25. S21 AB (assistive technolog*) N5 monitor* OR TI (assistive technolog*) N5 monitor* (21)

26. S20 AB ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health*) N8 monitor*) OR TI ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health) N8 monitor*) (1355)

27. S19 TI telemonitoring OR AB telemonitoring (916)

28. S18 TI (virtual N3 (ward* or healthcare or “health care” or hospital* or monitor*)) OR AB (virtual N3 (ward* or healthcare or “health care” or hospital* or monitor*)) (690)

29. S17 TI ((wearable* or sensing) N3 (device* or system* or technolog*)) OR AB((wearable* or sensing) N3 (device* or system* or technolog*)) (2702)

30. S16 TI ((body or motion or inertia* or wearable* or worn or activity or ingestible* or insertable or implant* or patch* or location* or GPS or global positioning or acceleromet* or gyroscop* or wireless or fitness) N3 (sensor* or tracker*)) OR AB ((body or motion or inertia or wearable* or worn or activity or ingestible* or insertable* or implant* or patch* or location* or GPS or global positioning or acceleromet* or gyroscop* or wireless or fitness) N3 (sensor* or sensing or tracker* or tracking) (5528)

31. S15 TI (biosensor* or biosensing) OR AB (biosensor* or biosensing) (635)

32. S14 TI “distant patient monitoring” OR AB “distant patient monitoring” (670)

33. S13 TI (remote* N3 (measurement* or supervision or surveillance)) OR AB (remote* N3 (measurement* or supervision or surveillance)) (224)

34. S12 TI ((remote* or digital or home*) N3 (sensor* or sensing or tracker* or tracking)) OR AB ((remote* or digital or home*) N3 (sensor* or sensing or tracker* or tracking)) (898)

35. S11 AB ((remote* or home* or digital or virtual or telephon* or smartphon* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) N3 monitor*) (9984)

36. S10 TI ((remote* or home* or digital or virtual or telephon* or smartphon* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) N3 monitor*) (3860)

37. S9 S1 OR S4 OR S5 OR S6 OR S7 OR S8 (18,509)

38. S8 S2 AND S3 (2957)

39. S7 (MH “Fitness Trackers”) (284)

40. S6 (MH “Wearable Sensors+”) (6386)

41. S5 (MH “Blood Pressure Monitoring, Ambulatory”) (4018)

42. S4 (MH “Electrocardiography, Ambulatory”) (3312)

43. S3 TI monitor* OR AB monitor* (172,095)

44. S2 (MH “Telehealth+”) (31,245)

45. S1 (MH “Telemetry”) (2178)

Web of Science Core Collection (Clarivate; search date 24 March 2022)

The web of science core collection includes the following databases: Science Citation Index Expanded; Social Sciences Citation Index; Arts and Humanities Citation Index; Conference Index – Science; Conference Proceedings Citation Index – Social Science and Humanities; and the Emerging Sources Citation Index.

34 #10 AND #30 and 2022 or 2021 or 2020 or 2019 or 2018 or 2017 or 2016 or 2015 or 2014 or 2013 or 2012 (Publication Years) and Chemistry Analytical or Geosciences Multidisciplinary or Physics Applied or Ecology or Biodiversity Conservation or Water Resources or Environmental Studies or Meteorology Atmospheric Sciences or Engineering Civil or Forestry or Green Sustainable Science Technology or Geochemistry Geophysics or Electrochemistry or Construction Building Technology or Energy Fuels or Plant Sciences or Engineering Industrial or Food Science Technology or Geography or Marine Freshwater Biology or Zoology or Agronomy or Veterinary Sciences or Agriculture Dairy Animal Science or Agriculture Multidisciplinary or Polymer Science or Physics Condensed Matter or Chemistry Inorganic Nuclear or Engineering Manufacturing or Mathematics Applied or Oceanography or Regional Urban Planning or Urban Studies or Engineering Chemical or Physics Multidisciplinary or Soil Science or Astronomy Astrophysics or Chemistry Applied or Engineering Mechanical or Geology or Limnology or Materials Science Ceramics or Metallurgy Metallurgical Engineering or Mathematics or Physics Atomic Molecular Chemical or Agricultural Economics Policy or Archaeology or Architecture or Crystallography or Engineering Geological or Entomology or Fisheries or Folklore or Industrial Relations Labor or Ornithology or Paleontology or Mining Mineral Processing or Physics Fluids Plasmas or Physics Mathematical or Transportation or Transportation Science Technology (Exclude – Web of Science Categories) and Environmental Sciences (Exclude – Web of Science Categories) and Geography Physical or Materials Science Multidisciplinary or Mathematical Computational Biology (Exclude – Web of Science Categories) 1729

1. 33 #10 AND #30 and 2022 or 2021 or 2020 or 2019 or 2018 or 2017 or 2016 or 2015 or 2014 or 2013 or 2012 (Publication Years) 2350

2. 32 #10 AND #30 2638

3. 31 #10 AND #30 2638

4. 30 #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 481,603

5. 29 ((remote* or home* or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or “smart watch” or ambulatory or app or apps or mobile* or device* or location* or GPS or “global positioning” or acceleromet* or gyroscop* or wearable*) NEAR/5 monitor*) (Title) 26,217

6. 28 ((remote* or home* or digital or virtual* or telephon* or smartphone* or phone* or smartwatch* or “smart watch” or ambulatory or app or apps or mobile* or device* or location* or GPS or “global positioning” or acceleromet* or gyroscop* or wearable*) NEAR/2 monitor*) (Abstract) 54,920

7. 27 ((remote* or digital or home*) NEAR/2 (sensor* or sensing or tracker or tracking)) (Title) or ((remote* or digital or home*) NEAR/2 (sensor* or sensing or tracker or tracking)) (Abstract) 143,327

8. 26 (remote* NEAR/2 (measurement* or supervision or surveillance)) (Title) or (remote* NEAR/2 (measurement* or supervision or surveillance)) (Abstract) 7137

9. 25 “distant patient monitoring” (Title) or “distant patient monitoring” (Abstract) 5

10. 24 biosensor* or biosensing (Title) 38,864

11. 23 ((body or motion or inertia* or wearable* or worn or activity or ingestible* or implant* or insertable or patch* or location* or GPS or “global positioning” or acceleromet* or gyroscop* or wireless or fitness) NEAR/2 (sensor* or sensing or tracker* or tracking)) (Title) or ((body or motion or inertia* or wearable* or worn or activity or ingestible* or implant* or insertable or patch* or location* or GPS or “global positioning” or acceleromet* or gyroscop* or wireless or fitness) NEAR/2 (sensor* or sensing or tracker* or tracking)) (Abstract) 172,971

12. 22 ((wearable* or sensing) NEAR/2 (device* or system* or technolog*)) (Title) or ((wearable* or sensing) NEAR/2 (device* or system* or technolog*)) (Abstract) 82,883

13. 21 (virtual NEAR/2 (ward* or healthcare or “health care” or hospital* or monitor*)) (Title) or (virtual NEAR/2 (ward* or healthcare or “health care” or hospital* or monitor*)) (Abstract) 1,848

14. 20 telemonitoring (Title) or telemonitoring (Abstract) 2478

15. 19 ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or “electronic health” or “electronic healthcare”) NEAR/8 monitor*) (Title) or ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or “electronic health” or “electronic healthcare”) NEAR/8 monitor*) (Abstract) 5071

16. 18 (assistive technolog* NEAR/5 monitor*) (Title) or (assistive technolog* NEAR/5 monitor*) (Abstract) 48

17. 17 (smart home* NEAR/5 monitor*) (Title) or (smart home* NEAR/5 monitor*) (Abstract) 654

18. 16 (smart house* NEAR/5 monitor*) (Title) or (smart house* NEAR/5 monitor*) (Abstract) 32

19. 15 (home automation NEAR/5 monitor*) (Title) or (home automation NEAR/5 monitor*) (Abstract) 200

20. 14 (“Internet of things” NEAR/5 monitor*) (Title) or (“Internet of things” NEAR/5 monitor*) (Abstract) 1880

21. 13 (gerontechnolog* NEAR/5 monitor*) (Title) or (gerontechnolog* NEAR/5 monitor*) (Abstract) 1

22. 12 “electronic patient reported outcome” (Title) or “electronic patient reported outcome” (Abstract) 217

23. 11 ePROM or ePROMs or ePRO or ePROs (Title) or ePROM or ePROMs or ePRO or ePROs (Abstract) 958

24. 10 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 524,827

25. 9 metaanalysis or meta-analysis or metasynthesis or meta-synthesis (Title) or metaanalysis or meta-analysis or metasynthesis or meta-synthesis (Abstract) 260,900

26. 8 systematic NEAR/1 (review or overview or search*) (Title) or systematic NEAR/1 (review or overview or search*) (Abstract) 303,005

27. 7 systematically NEAR/1 (review* or search*) (Abstract) 36,013

28. 6 TI = (evidence synthesis or “review of reviews”) OR AB = (evidence synthesis or “review of reviews”) 70,987

29. 5 thematic synthesis (Title) or thematic synthesis (Abstract) 2610

30. 4 evidence NEAR/2 map* (Title) or evidence NEAR/2 map* (Abstract) 2847

31. 3 TI=(((scoping or rapid or realist or mapping or umbrella) NEAR/2 review)) OR AB = (((scoping or rapid or realist or mapping or umbrella) NEAR/2 review)) 24,788

32. 2 (qualitative NEAR/2 synthesis) (Title) or (qualitative NEAR/2 synthesis) (Abstract) 4813

33. 1 ((mixed-stud* or mixed-method*) NEAR/2 review) (Title) or ((mixed-stud* or mixed-method*) NEAR/2 review) (Abstract) 1183

Scopus (Elsevier; search date 30 March 2022)

Restricted to: medicine, computer science, engineering, biochem, health professions, social sciences, psychology, pharmacy, immunology, dentistry

(((TITLE-ABS((telecare OR telemedicine OR telemetry OR telehealth* OR m-health* OR mhealth* OR e-health* OR ehealth* OR “electronic health*”) W/8 monitor*))) and (((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis}))))) or ((((TITLE(virtual W/2 (monitor*)))) or ((TITLE-ABS(virtual W/2 (“health care”)))) or ((TITLE-ABS(virtual W/2 (healthcare)))) or ((TITLE-ABS(virtual W/2 (ward*)))) or ((TITLE-ABS(virtual W/2 (ward* OR healthcare OR “health care” OR hospital* OR monitor*)))) or ((TITLE-ABS({telemonitoring}))) or ((TITLE-ABS(“assistive technolog*” W/5 monitor*))) or ((TITLE-ABS(“smart home*” W/5 monitor*))) or ((TITLE-ABS(“smart house*” W/5 monitor*))) or ((TITLE-ABS(“home automation” W/5 monitor*))) or ((TITLE-ABS(“Internet of things” W/5 monitor*))) or ((TITLE-ABS(gerontechnolog* W/5 monitor*))) or ((TITLE-ABS({electronic patient reported outcome}))) or ((TITLE-ABS({ePROM} OR {ePROMs} OR {ePRO} OR {ePROs})))) and (((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis}))))) or ((((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis})))) and ((TITLE((remote* OR home* OR digital OR virtual* OR telephon* OR smartphone* OR phone* OR smartwatch* OR “smart watch*” OR ambulatory OR app OR apps OR mobile* OR device* OR location* OR GPS OR “global positioning” OR acceleromet* OR gyroscop* OR wearable*) W/5 (monitor*))))) or ((((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis})))) and ((ABS((home* OR digital OR virtual* OR telephon* OR smartphone* OR phone* OR smartwatch* OR “smart watch*” OR ambulatory OR app OR apps OR mobile* OR location* OR GPS OR “global positioning” OR acceleromet* OR gyroscop* OR wearable*) W/2 (monitor*))))) or ((((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis})))) and ((TITLE-ABS((remote* OR digital OR home*) W/2 (sensor* OR sensing OR tracker OR tracking))))) or ((((TITLE-ABS({review of reviews}))) or ((TITLE-ABS((mixed-stud* OR (mixed W/1 stud*) OR (mixed W/1 method*) OR mixed-method*) W/2 review))) or ((TITLE-ABS(qualitative W/2 synthesis))) or ((TITLE-ABS(evidence W/2 map*))) or ((TITLE-ABS({thematic synthesis}))) or ((TITLE-ABS({evidence synthesis}))) or ((ABS(systematically W/1 (review* OR search*)))) or ((TITLE-ABS(systematic W/1 (review OR overview OR search*)))) or ((TITLE({metaanalysis} OR {meta-analysis} OR {metasynthesis} OR {meta-synthesis})))) and ((TITLE-ABS((body OR motion OR inertia* OR wearable* OR worn OR activity OR ingestible* OR implant* OR insertable OR patch* OR location* OR GPS OR “global positioning” OR acceleromet* OR gyroscop* OR wireless OR fitness) W/2 (sensor* OR sensing OR tracker* OR tracking))))) AND (LIMIT-TO (PUBYEAR,2022) OR LIMIT-TO (PUBYEAR,2021) OR LIMIT-TO (PUBYEAR,2020) OR LIMIT-TO (PUBYEAR,2019) OR LIMIT-TO (PUBYEAR,2018) OR LIMIT-TO (PUBYEAR,2017) OR LIMIT-TO (PUBYEAR,2016) OR LIMIT-TO (PUBYEAR,2015) OR LIMIT-TO (PUBYEAR,2014) OR LIMIT-TO (PUBYEAR,2013) OR LIMIT-TO (PUBYEAR,2012)) AND (LIMIT-TO (SUBJAREA,”MEDI”) OR LIMIT-TO (SUBJAREA,”COMP”) OR LIMIT-TO (SUBJAREA,”ENGI”) OR LIMIT-TO (SUBJAREA,”BIOC”) OR LIMIT-TO (SUBJAREA,”HEAL”) OR LIMIT-TO (SUBJAREA,”SOCI”) OR LIMIT-TO (SUBJAREA,”PSYC”) OR LIMIT-TO (SUBJAREA,”PHAR”) OR LIMIT-TO (SUBJAREA,”IMMU”) OR LIMIT-TO (SUBJAREA,”DENT”))

Cochrane Database of Systematic Reviews (Wiley; search date 28 March 2022)

www.cochranelibrary.com

Custom date range: from 01/01/2012 onwards

1. #1 MeSH descriptor: [Remote Sensing Technology] explode all trees

2. #2 MeSH descriptor: [Telemetry] explode all trees

3. #3 MeSH descriptor: [Telemedicine] explode all trees

4. #4 (monitor*):ti,ab,kw

5. #5 #3 AND #4

6. #6 MeSH descriptor: [Monitoring, Ambulatory] explode all trees

7. #7 MeSH descriptor: [Wearable Electronic Devices] explode all trees

8. #8 MeSH descriptor: [Fitness Trackers] explode all trees

9. #9 ((remote* or home* or digital or virtual or telephon* or smartphon* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) near/2 monitor*):ti,ab,kw

10. #10 ((remote or digital or home*) near/2 (sensor* or sensing or tracker* or tracking)):ti,ab,kw

11. #11 (remote* near/2 (measurement* or supervision or surveillance)):ti,ab,kw

12. #12 (“distant patient monitoring”):ti,ab,kw

13. #13 (biosensor* or biosensing):ti

14. #14 ((body or motion or inertia* or wearable* or worn or activity or ingestible* or insertable or implant* or patch* or location* or GPS or global positioning or gyroscop* or wireless or fitness) near/2 (sensor* or sensing or tracker* or tracking)):ti,ab,kw

15. #15 ((wearable* or sensing) near/2 (device* or system* or technolog*)):ti,ab,kw

16. #16 (virtual near/2 (ward* or healthcare or “health care” or hospital* or monitor*)):ti,ab

17. #17 telemonitoring:ti,ab,kw

18. #18 ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health*) near/8 monitor*):ti,ab,kw

19. #19 ((assistive technolog*) near/5 monitor*):ti,ab,kw

20. #20 ((smart home*) near/5 monitor*):ti,ab,kw

21. #21 ((smart house*) near/5 monitor*):ti,ab,kw

22. #22 ((“home automation”) near/5 monitor*):ti,ab,kw

23. #23 ((“internet of things”) near/5 monitor*):ti,ab,kw

24. #24 (gerontechnolog* near/5 monitor*):ti,ab,kw

25. #25 “electronic patient reported outcome”:ti,ab,kw

26. #26 (ePROM or ePROMs or ePRO or ePROs):ti,ab,kw

27. #27 #1 or #2 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 (113, limited to 1/1/2012: 97)

PROSPERO (Centre for Reviews and Dissemination, University of York; search date 28 March 2022)

www.crd.york.ac.uk/prospero

1. #1 MeSH DESCRIPTOR Remote Sensing Technology EXPLODE ALL TREES 1

2. #2 MeSH DESCRIPTOR Telemetry EXPLODE ALL TREES 4

3. #3 MeSH DESCRIPTOR Telemedicine EXPLODE ALL TREES 724

4. #4 monitor* 7031

5. #5 #3 AND #4 199

6. #6 MeSH DESCRIPTOR Monitoring, Ambulatory EXPLODE ALL TREES 59

7. #7 MeSH DESCRIPTOR Wearable Electronic Devices EXPLODE ALL TREES 105

8. #8 MeSH DESCRIPTOR Fitness Trackers EXPLODE ALL TREES 28

9. #9 (((remote* or home* or digital or virtual* or telephon* or smartphon* or phone* or smartwatch* or smart watch* or ambulatory or app or apps or mobile* or device* or location* or GPS or global positioning or acceleromet* or gyroscop* or wearable*) AND monitor*)):TI 132

10. #10 (((remote* or digital or home*) AND (sensor* or sensing or tracker* or tracking))):TI 11

11. #11 (((remote*) AND (measurement* or supervision or surveillance))):TI 7

12. #12 (“distant patient monitoring”):TI 0

13. #13 “distant patient monitoring” 0

14. #14 (biosensor or biosensing):TI 2

15. #15 (((body or motion or inertia* or wearable* or worn or activity or ingestible* or implant* or insertable or patch* or location* or GPS or global positioning or acceleromet* or gyroscop* or wireless or fitness) AND (sensor* or sensing or tracker* or tracking))):TI 84

16. #16 (((wearable* or sensing) AND (device* or system* or technolog*))):TI 144

17. #17 ((virtual AND (ward* or healthcare or health care or hospital* or monitor*))):TI 18

18. #18 telemonitoring 163

19. #21 ((telecare or telemedicine or telemetry or telehealth* or m-health* or mhealth* or e-health* or ehealth* or electronic health*) AND monitor*):TI 8

20. #22 “assistive technology” AND monitor* 23

21. #23 smart home* AND monitor* 10

22. #24 smart house* AND monitor* 1

23. #27 home automation AND monitor* 1

24. #30 “internet of things” AND monitor* 10

25. #33 gerontechnolog* AND monitor* 4

26. #36 “electronic patient reported outcome” 11

27. #39 eprom or eproms or epro or epros 14

28. #42 #1 OR #2 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #21 OR #22 OR #23 OR #24 OR #27 OR #30 OR #33 OR #36 OR #39 753

OT Seeker (search date 30 March 2022)

www.otseeker.com

Total records: 49

1. Any Field: remote* AND Method: Systematic Review: 12

2. Any Field: wearable* AND Method: Systematic Review: 3

3. Any Field: telemonitoring AND Method: Systematic Review: 4

4. Any Field: telemetry AND Method: Systematic Review 1

5. Any Field: telecare AND Method: Systematic Review: 11

6. Any Field: telemedicine AND monitor* AND Method: Systematic Review: 5

7. Any Field: telehealth* AND monitor* AND Method: Systematic Review 0

8. Any Field: ehealth* AND monitor* AND Method: Systematic review 2

9. Any Field: e-health* AND monitor* AND Method: Systematic Review 3

10. Any Field: mhealth* AND monitor* AND Method: Systematic Review 0

11. Any Field: m-health* AND monitor* AND Method: Systematic Review 6

12. Any Field: virtual AND monitor* AND Method: Systematic Review 2

13. Any Field: virtual AND ward* AND Method: Systematic Review 0

14. Any Field: biosensor* AND Method: Systematic Review 0

PEDro (search date 28 March 2022)

https://pedro.org.au

Total: 125 records (not deduplicated)

1. Title/Abstract: remote* AND Method: Systematic Review 47

2. Title/Abstract: wearable* AND Method: Systematic Review: 35

3. Title/Abstract: telemonitoring AND Method: Systematic Review: 12

4. Title/Abstract: telemetry AND Method: Systematic Review 2

5. Title/Abstract: telecare AND Method: Systematic Review 0

6. Title/Abstract: telemedicine monitor* AND Method: Systematic Review 4

7. Title/Abstract: telehealth* monitor* AND Method: Systematic Review 4

8. Title/Abstract: ehealth* monitor* AND Method: Systematic review 7

9. Title/Abstract: e-health* monitor* AND Method: Systematic Review 3

10. Title/Abstract: mhealth* monitor* AND Method: Systematic Review 4

11. Title/Abstract: m-health* monitor* AND Method: Systematic Review 2

12. Title/Abstract: virtual monitor* AND Method: Systematic Review 5

13. Title/Abstract: virtual ward* AND Method: Systematic Review 0

14. Title/Abstract: biosensor* AND Method: Systematic Review 0

ProQuest Dissertations and Theses Global (search date 31 March 2022)

(title(qualitative NEAR/2 synthesis) OR abstract(qualitative NEAR/2 synthesis) OR abstract((mixed-stud* or mixed-method*) NEAR/2 (review)) OR title((mixed-stud* or mixed-method*) NEAR/2 (review)) OR title((scoping or rapid or realist or mapping or umbrella) NEAR/2 (review)) OR abstract((scoping or rapid or realist or mapping or umbrella) NEAR/2 (review)) OR (abstract(evidence NEAR/2 map*) OR title(evidence NEAR/2 map*)) OR (abstract(thematic synthesis) OR title(thematic synthesis)) OR (abstract(evidence synthesis or “review of reviews”) OR title(evidence synthesis or “review of reviews”)) OR abstract((systematically) NEAR/1 (review* or search)) OR abstract((systematic) NEAR/1 (review or overview or search*)) OR title((systematic) NEAR/1 (review or overview or search*)) OR (title(metaanalysis or meta-analysis or metasynthesis or meta-synthesis) OR abstract(metaanalysis or meta-analysis or metasynthesis or meta-synthesis))) AND ((title(remote* OR home* OR digital OR virtual* OR telephon* OR smartphone* OR phone* OR smartwatch* OR “smart watch” OR ambulatory OR app OR apps OR mobile* OR device* OR location* OR GPS OR “global positioning” OR acceleromet* OR gyroscop* OR wearable*) AND (title(monitor* OR sensor* OR sensing OR tracker OR tracking) OR abstract(monitor* OR sensor* OR sensing OR tracker OR tracking))) OR (title(measurement* OR supervision OR surveillance) AND title(remote*)) OR title(sensor* OR sensing OR tracker* OR tracking) OR title(wearable*) OR (abstract(wearable*) AND abstract(device* OR system* OR technolog*)) OR (title(telecare OR telemedicine OR telemetry OR telehealth* OR m-health* OR mhealth* OR e-health* OR ehealth* OR “electronic health” OR “electronic healthcare”) AND title(monitor*)) OR (abstract(telecare OR telemedicine OR telemetry OR telehealth* OR m-health* OR mhealth* OR e-health* OR ehealth* OR “electronic health” OR “electronic healthcare”) AND abstract(monitor*)))

Epistemonikos (search date 30 March 2022)

www.epistemonikos.org/

Total: 2171

Duplicates and pre-2012 removed: 376

Copied across: 1795

Google Scholar (search date: 30 March 2022)

1. Searched via Publish or Perish (Harzing)

2. Google Scholar (all in title) using Publish or Perish

3. Remote monitoring and systematic review = 46

4. Wearable and systematic = 164

5. Mobile and health and systematic = 235

6. De-duped in separate library

7. 383 records copied to main EndNote library

Cardiovascular disease (36)

1. Al-Abdouh A, Mahmoud B, Jabri A. Efficacy of implanted device telemonitoring in patients with heart failure: a meta-analysis of randomized controlled trials. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=238122

2. Azmi Nabila KA, Noor MI, Wibowo RA, Sofro ZM. Evaluating the effectiveness of telemonitoring in primary hypertension management: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=268119

3. Brahmbhatt D, Cowie M, Gallagher A. Facilitators and barriers to effective remote monitoring of heart failure patients using cardiovascular implantable electronic devices. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=100043

4. Calderon EHC. Effect of remote monitoring of implantable cardiac pacemakers. A systematic review and meta-analysis of randomized controlled trials. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=203615

5. Cheong A, Xu F, Wang S. Outcomes in patients with CIEDs followed up via remote monitoring: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=277010

6. de Barros K, Martins MAP, Praxedes M, Ribeiro ALP. Effectiveness and usability of mobile health applications for medication adherence in patients with heart failure: a systematic review protocol. JBI Evid Synth 2021;19:2777–82. https://doi.org/10.11124/JBIES-20-00399

7. Fatrin S, Auliani S, Pratama S, Margaret SP, Brunner TM, Siswanto BB. Outcome of telemedicine in heart failure patients. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=271540

8. Hwang M, Aekyung Chang A. The effect of nurse-led digital health intervention for patient with hypertension: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=2

9. Igai Y, Negishi Y, Kato E, Ishikawa K, Harada T, Kamei T. Effectiveness of telemonitoring by healthcare providers on health outcomes for patients with chronic heart failure: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=237639

10. Jin K, Hafiz N. Evidences on the cardiovascular benefits in the use of wearable devices in adults with cardiovascular disease? PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=162045

11. Kelly S, Wells G. Qualitative synthesis of patient- and healthcare provider-reported barriers to virtual follow-up and care models for patients with cardiovascular implantable electronic devices. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=160533

12. Koo K, Ferguson C, Liang-Han L, Cleland J, Inglis S. Implantable device monitoring versus usual care for managing individuals with heart failure [Cochrane protocol]. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=148354

13. Lee WL, Syazwani N, Zulfazli I, Suhaimi RA. A systematic review protocol on the use and the effectiveness of wearable electronic activity tracking system (EATs) for patients with coronary heart disease undergoing cardiac rehabilitation program. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=106366

14. Maximidou T, Mons U. Impact of wearable activity trackers on the prognosis of coronary artery disease – a systematic review and meta-analysis of randomized controlled trials. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=252651

15. McGee M, Ray M, Sverdlov A. Benefits of remote monitoring in patients with cardiac implantable electronic devices who have heart failure: systematic review. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=129270

16. Mikulski B, De Marchi A. Effects of using mHealth apps on medication adherence in patients with arterial hypertension. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=205973

17. Moura Dantas de Lima T, da Silva de Lima e Silva EH, Santos da Costa MG. Systematic review of remote monitoring in patients with implantable cardioverter defibrillator (ICD) with ventricular arrhythmia. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=242864

18. Nagy KV, Hernandez-Montfort J, Al-Hussaini A, Stafylas P. Contemporary non-invasive remote monitoring longitudinal impact in adults with chronic systolic heart failure related hospital admissions: systematic review and meta-analysis. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=145815

19. Ogbu I, Dota A. Remote pulmonary artery hemodynamic monitoring in chronic heart failure: Systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=261416

20. Patel H, King-Shier K, Hayden A. A systematic review of wearable monitoring technology for heart failure management. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=209743

21. Pei X. The effectiveness of telemedicine interventions in high blood pressure monitoring: a systematic review and meta-analysis. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=211461

22. Rebolledo Del Toro M, Muñoz Velandia OM, García Peña AA, Fernández Ávila DG, Barahona Correa JE, Herrera Leaño NM. Effectiveness of mobile telemonitoring applications in heart failure patients. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=299516

23. Reis L, Mesquita E, Carraro A, Périssé L, Neto N, Rodrigues T, et al. Telemedicine in heart failure during the pandemic: a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=224057

24. Scholte N, Gürgöze M, Aydin D, van der Boon R, Brugts J, Boersma E. Effects of non-invasive and invasive telemonitoring on heart failure outcomes: a state-of-the-art systematic review and meta-analysis. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=306677

25. Srigati SA, Aliyah SF, Aryasatya DWB. The impact of telemedicine for heart failure management during COVID-19 pandemic: a systematic review of cohort studies. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=306241

26. Somberg C, Eastland T, Allen J, Schooley A. Effect of nurse-led telehealth on rehospitalization and quality of life among community-dwelling adults with heart failure: a quantitative systematic review protocol. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=313122

27. Thanigaimani S, Golledge J. Systematic review of sensors and wearables to improve walking performance in peripheral artery disease. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=308138

28. Tourais Matos Sousa JM, Moreira E, Sousa Pinto BS, Viana Pinto J, Pinto R, Azevedo LF, et al. Effectiveness of non-invasive home telemonitoring in outpatient care for patients with heart failure: a systematic review and meta-analysis. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=146396

29. Tourais Matos Sousa JM, Silva Cardoso JS, Azevedo LF, Moreira RPE. The effectiveness of non-invasive home telemonitoring in outpatient care for patients with heart failure: a systematic review. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=88522

30. Veres B, Schwertner W, Kiss B, Engh M, Kosztin A, Merkely B. Continuous invasive remote monitoring in patients with heart failure compared to regular in-clinic follow-up: A systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=299820

31. Warraich H, Maqsood MH. Telemonitoring in heart failure patients: an updated systematic review and meta-analysis. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=184381

32. Wireklint Sundstroem B, Josephsson H, Olofsson S. Patient participation in self-monitoring in case of heart failure and home-based care, by means of patient experiences: a integrative systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=244252

33. Wu Y, Zhao P, Li W, Cao MQ, Du L, Chen JC. The effect of remote health intervention based on internet or mobile communication network on hypertension patients: protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019;98:e14707. https://doi.org/10.1097/MD.0000000000014707

34. Yong J. Effects of wearable devices in adults with cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=186489

35. Zhiqiang Wang Z, Jin X, Tang Z, Kang Y. The practical effect of remote cardiac rehabilitation technology on patients with heart disease. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=271283

36. Zito A, Princi G, Romiti GF. Remote monitoring strategies for guided management of patients with heart failure: a systematic review and meta-analysis. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=308167

Neurological conditions (8)

1. de Barros Gonze B, di Paschoale Ostolin TLV. Effectiveness of telehealth oriented to the attention and care of adults with neurological diseases before and during the COVID-19 pandemic: a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=250334

2. Gebrye T, Fatoye F, Anazodo C. Effect of tele-rehabilitation on quality of life in stroke patients: a systematic review and meta analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=295888

3. Harris P. Factors influencing physical activity sensor use for self-management in stroke patients and older at-risk adults – a systematic review and thematic synthesis. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=211472

4. Quel de Oliveira C, Scianni A, Vehagen A. Telerehabilitation to improve functional outcomes in individuals with neurological conditions. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=160327

5. Seri E, Bilotta F. Technology-assisted clinical management of brain injured patients after hospital discharge. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=255515

6. Wade R, Simmonds M, Meader N, Fulbright H. Devices for remote continuous monitoring of people with Parkinson&#39;s disease: a systematic review and economic analysis. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=308597

7. Wilchesky M, Guseva E, Iaboni A, Hermann N, Kumar S, Seitz D, et al. Wearable sensor technology for assessment and monitoring of neuropsychiatric symptoms of dementia. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=219917

8. Yan Y, Chan ML, Kwok JYY, Jung Jae Lee J. The effect of mobile health interventions on hyperlipidaemia control among stroke patients: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=281946

Diabetes (10)

1. Adams D, Zheng H, Sinclair M, Murphy M, McCullough J. Wearable technologies in type one diabetes pregnancy: a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=261671

2. Alvarez SD, Sculley D, Santos D, Acharya SH, Garcia XG, Wynne K-J, Coda A. The role of smartwatch technology in the provision of care for type 1 or type 2 diabetes mellitus or gestational diabetes: a systematic review. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=136825

3. Colley J, Dambha-Miller H, Stuart B, Bartholomew J, Price H. Home monitoring of HbA1c in diabetes mellitus: A protocol for systematic review and narrative synthesis on reliability, accuracy, and patient acceptability. medRxiv 2021. https://dx.doi.org/10.1101/2021.12.15.21267851

4. Colley J, Price H, Dambha-Miller H, Stuart B, Bartholomew J. Home monitoring of HbA1c in diabetes mellitus: a systematic review and narrative synthesis on reliability, accuracy and patient acceptability. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=225606

5. Endo M, Yamamoto Y, Kamei T. Effect of telehome-monitoring-based telenursing in people with type 2 diabetes: A systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=273579

6. Jones P, Webb D, Davies M, Khunti K, McCarthy M. Attitudes to wearable technology to prevent foot ulceration in people with diabetes and neuropathy: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=164449

7. Luz S, Henriques H, Ferraz I, Lapão L, Guerreiro M, Emilia M, et al. The effects of telehealth on the health literacy of people with type 2 diabetes: a systematic review. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=94910

8. Siddiqui S, Gillies C, Gray L. The effectiveness of telemedicine interventions for glycaemic control in patients with Type 2 diabetes: A systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=255164

9. Sun J, Cai J, Jiang S, Xu H, Broadley S. Effectiveness of telemonitoring intervention using resilience theory based patient self care approach on glycaemic outcomes in patients with type 2 diabetes mellitus. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=265979

10. Yong J. Effect of wearable devices on diabetes in adults: a systematic review and meta-analysis of RCT. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=152297

Respiratory conditions (13)

1. Alghamdi SM, Janaudis-Ferreira T, Alhasani R, Ahmed S. Acceptance, adherence and dropout rates of individuals with COPD approached in telehealth interventions: a protocol for systematic review and meta-analysis. BMJ Open 2019;9:e026794. http://dx.doi.org/10.1136/bmjopen-2018-026794

2. Anand R, McLeese R, Stewart J, Busby J, Clarke M, Bradley J. Unsupervised remote spirometry vs supervised clinic spirometry: a protocol for a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=272816

3. Gaveikaite V, Fischer C, Schonenberg H, Pauws S, Kitsiou S, Chouvarda I, et al. Telehealth for patients with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis protocol. BMJ Open 2018;8:e021865. http://dx.doi.org/10.1136/bmjopen-2018-021865

4. Gaveikaite V, Fisher C, Schonenberg H, Kitsiou S, Chouvarda I, Pauws S, et al. Systematic review and meta-analysis of telehealth for COPD patients. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=8367

5. Harris K, Grigg J. The use of electronic monitoring devices in adherence with asthma medications, and their impact on patient outcomes: a systematic review. PROSPERO 2019. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=127361

6. Igai Y, Otomo S, Minami K, Kamei T. Effectiveness of telemonitoring by healthcare providers on health outcomes for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=236505

7. Isernia S, Pagliari C, Baglio F, Banfi P, Rossetto F, Borgnis F. Telerehabilitation for people with chronic obstructive pulmonary disease. A systematic review and meta-analysis. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=277381

8. Valenza MC. eHealth assessment tools in COPD patients: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=213189

9. Martin-Valero R, Ortíz-Ortigosa L, Viñolo-Gil MJ. Telerehabilitation and telemonitoring interventions programs used to improving quality of life in people with cystic fibrosis: a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=257647

10. Sarasmita MA, Lo A, Yin Chen HY. Effectiveness of mobile health-based self-management interventions to reduce exacerbation and improve health-related quality of life in patients with COPD: a systematic review and meta-analysis. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=181157

11. Shah A, Althobiani M, Saigal A, Hurst J, Mandal S. Home wearable technology in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=299706

12. Shehraj S. The feasibility and effectiveness of digital technology for monitoring cough in chronic respiratory illness: a systematic review. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=306474

13. Ward C, Ha J, Lewis A, Conway J, Parrott H. The remote monitoring of inhaler adherence and technique in asthma: a systematic review. PROSPERO 2022. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=299468

Cancer survivors (0)

Not clearly defined/reported (11)

1. Dermody G, Glass C, Dunham M, Fritz R. The factors affecting clinician readiness to adopt smart home technology for remote health monitoring: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=195989

2. Facchinetti G, Petrucci G, Piredda M, Matarese M, Grazia De Marinis M. The impact of smart home technology on chronic diseases in older people: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=137480

3. Gonçalves RL, Pagano AS, Reis Z, Afagbedzi SK, Head M, Kenny Brackstone K, et al. Telehealth usability evaluation by healthcare professionals in post-pandemic non-communicable disease (hypertension and diabetes) treatment: a systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=296887

4. Harrison C, Porter I, Valderas J, Sidey-Gibbons C. Remote monitoring using patient reported outcomes: the effect on survival. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=178753

5. Mattison G, Forrester D, Sullivan C, Dobbins C, Toyras J. The influence of wearable technology on healthcare outcomes in chronic disease – A systematic review. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=244562

6. Muller AE, Berg RC. A flexible protocol for a systematic review of remote patient monitoring. Prim Health Care Res Dev 2020;21:e45. http://dx.doi.org/10.1017/S1463423620000262

7. Prats Vila A, Chabrera C. The use of mHealth for the monitoring and control of patients with chronic diseases: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=198461

8. Ruben D, de Rezende B, Andrade I, Leonardo N, Carvalho C. Better outcomes for monitoring, evaluation and rehabilitation through telehealth for adults and aged with chronic diseases, in randomized controlled trials. PROSPERO 2021. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=247886

9. Shahid N, Rac VE, Bielecki J, Berta W. Understanding factors critical to the implementation of ehealth in chronic disease management: a realist review protocol. BMJ Open 2021;11:e048250. http://dx.doi.org/10.1136/bmjopen-2020-048250

10. Wagle NS, Schueler J, Engler S, Fields S, Kum HC. Patient-perceived barriers and facilitators of using remote health technology to manage diabetes and cardiovascular disease in underserved adult populations: a systematic review. PROSPERO 2020. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=161474

11. Welleman O, Prins-van Gilst G. Telemonitoring in the ambulatory care: a systematic review. PROSPERO 2018. URL: www.crd.york.ac.uk/prospero/display_record.php?RecordID=105589

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