Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review.
COVID-19 has tragically taken the lives of more than 6.5 million people globally, significantly challenging healthcare systems and service delivery, especially in low-and middle-income countries (LMICs). This systematic review aims to: (1) evaluate the feasibility of telemedicine interventions for C...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2025-04-01
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| Series: | PLOS Digital Health |
| Online Access: | https://doi.org/10.1371/journal.pdig.0000771 |
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| author | Nonye M Okafor Imani Thompson Vandana Venkat Courtney Robinson Aishwarya Rao Sumedha Kulkarni Leah Frerichs Khady Ndiaye Deborah Adenikinju Chukwuemeka Iloegbu John Pateña Hope Lappen Dorice Vieira Joyce Gyamfi Emmanuel Peprah |
| author_facet | Nonye M Okafor Imani Thompson Vandana Venkat Courtney Robinson Aishwarya Rao Sumedha Kulkarni Leah Frerichs Khady Ndiaye Deborah Adenikinju Chukwuemeka Iloegbu John Pateña Hope Lappen Dorice Vieira Joyce Gyamfi Emmanuel Peprah |
| author_sort | Nonye M Okafor |
| collection | DOAJ |
| description | COVID-19 has tragically taken the lives of more than 6.5 million people globally, significantly challenging healthcare systems and service delivery, especially in low-and middle-income countries (LMICs). This systematic review aims to: (1) evaluate the feasibility of telemedicine interventions for COVID-19 management; (2) assess the adoption of telemedicine interventions during the COVID-19 pandemic; (3) examine the cost-effectiveness of telemedicine implementation efforts and (4) analyze the sustainability of telemedicine interventions for COVID-19 disease management within LMIC service settings. We reviewed studies from selected public health and health science databases, focusing on those conducted in countries classified as low and middle-income by the World Bank, using telemedicine for confirmed COVID-19 cases, and adhering to Proctor's framework for implementation outcomes. Of the 766 articles identified and 642 screened, only 3 met all inclusion criteria. These studies showed reduced reliance on antibiotics, prescription drugs, and emergency department referrals among telemedicine patients. Statistical parity was observed in the length of stay, diagnostic test ordering rates, and International Classification of Diseases (ICD)-10 diagnoses between telemedicine and in-person visits. Telemedicine interventions designed for post-COVID physical rehabilitation demonstrated safety, sustainability, and enhanced quality of life for patients without requiring specialized equipment, proving adaptable across contexts with appropriate technology. These interventions were also economically sustainable and cost-effective for healthcare systems as a whole. Proposed strategies to bridge implementation gaps include community-level assessments, strategic planning, multisectoral partnerships of local hospital administration and lawmakers, legal consultations, and healthcare informatics improvements. Increased investment in telemedicine research focusing on infectious disease management is crucial for the continued development and refinement of effective strategies tailored to resource-constrained regions. |
| format | Article |
| id | doaj-art-451a8dfd7b394656bf4346d771d8003f |
| institution | OA Journals |
| issn | 2767-3170 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Digital Health |
| spelling | doaj-art-451a8dfd7b394656bf4346d771d8003f2025-08-20T02:17:33ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702025-04-0144e000077110.1371/journal.pdig.0000771Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review.Nonye M OkaforImani ThompsonVandana VenkatCourtney RobinsonAishwarya RaoSumedha KulkarniLeah FrerichsKhady NdiayeDeborah AdenikinjuChukwuemeka IloegbuJohn PateñaHope LappenDorice VieiraJoyce GyamfiEmmanuel PeprahCOVID-19 has tragically taken the lives of more than 6.5 million people globally, significantly challenging healthcare systems and service delivery, especially in low-and middle-income countries (LMICs). This systematic review aims to: (1) evaluate the feasibility of telemedicine interventions for COVID-19 management; (2) assess the adoption of telemedicine interventions during the COVID-19 pandemic; (3) examine the cost-effectiveness of telemedicine implementation efforts and (4) analyze the sustainability of telemedicine interventions for COVID-19 disease management within LMIC service settings. We reviewed studies from selected public health and health science databases, focusing on those conducted in countries classified as low and middle-income by the World Bank, using telemedicine for confirmed COVID-19 cases, and adhering to Proctor's framework for implementation outcomes. Of the 766 articles identified and 642 screened, only 3 met all inclusion criteria. These studies showed reduced reliance on antibiotics, prescription drugs, and emergency department referrals among telemedicine patients. Statistical parity was observed in the length of stay, diagnostic test ordering rates, and International Classification of Diseases (ICD)-10 diagnoses between telemedicine and in-person visits. Telemedicine interventions designed for post-COVID physical rehabilitation demonstrated safety, sustainability, and enhanced quality of life for patients without requiring specialized equipment, proving adaptable across contexts with appropriate technology. These interventions were also economically sustainable and cost-effective for healthcare systems as a whole. Proposed strategies to bridge implementation gaps include community-level assessments, strategic planning, multisectoral partnerships of local hospital administration and lawmakers, legal consultations, and healthcare informatics improvements. Increased investment in telemedicine research focusing on infectious disease management is crucial for the continued development and refinement of effective strategies tailored to resource-constrained regions.https://doi.org/10.1371/journal.pdig.0000771 |
| spellingShingle | Nonye M Okafor Imani Thompson Vandana Venkat Courtney Robinson Aishwarya Rao Sumedha Kulkarni Leah Frerichs Khady Ndiaye Deborah Adenikinju Chukwuemeka Iloegbu John Pateña Hope Lappen Dorice Vieira Joyce Gyamfi Emmanuel Peprah Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. PLOS Digital Health |
| title | Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. |
| title_full | Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. |
| title_fullStr | Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. |
| title_full_unstemmed | Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. |
| title_short | Evaluating the feasibility, adoption, cost-effectiveness, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. |
| title_sort | evaluating the feasibility adoption cost effectiveness and sustainability of telemedicine interventions in managing covid 19 within low and middle income countries lmics a systematic review |
| url | https://doi.org/10.1371/journal.pdig.0000771 |
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