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Tran HP, Nguyen NN, Ho NT, Tran TTT, Ly LT, Hoang TTD, Le DTP, Tzeng CR, Vo VT, Tran LG. The impacts of telemedicine on assisted reproduction: a systematic review and meta-analysis. Reprod Biomed Online 2024; 48:103752. [PMID: 38489925 DOI: 10.1016/j.rbmo.2023.103752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/14/2023] [Accepted: 10/24/2023] [Indexed: 03/17/2024]
Abstract
Telemedicine is being applied in assisted reproduction technology (ART) to provide remote consultations, monitoring and support for patients. This study aimed to evaluate the potential advantages of telemedicine in ART treatment in the form of virtual consultations. Studies in which patients were using telemedicine during ART treatment were identified from four scientific databases (PudMed, EMBASE, Scopus, Web of Science). The success of fertility treatments was compared between telemedicine and in-office care, and patient satisfaction with ART through telemedicine was assessed. Eleven studies, comprising 4697 patients, were identified. Quality assessment (Joanna Briggs Institute Critical Appraisal and revised Cochrane risk-of-bias tools) revealed an acceptable risk of bias for both randomized controlled trials and observational studies. Using a fixed-effects model, telemedicine was comparable to in-person care regarding the pregnancy rate achieved (odds ratio 1.02, 95% confidence intervals 0.83-1.26, P = 0.83). A Q-test suggested that all the included studies were homogeneous. Patients who received telemedicine during fertility treatment reported a high level of satisfaction (91%, 95% confidence intervals 80-96%). Egger's test confirmed that no publication bias was found. Telemedicine could serve as a complementary tool during fertility treatment to facilitate patients' satisfaction and overcome some practical problems without compromising treatment outcomes. Future studies should continue exploring the potential applications of telemedicine in assisted reproduction.
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Affiliation(s)
- Huy Phuong Tran
- Infertility Department, Hung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Nam Nhat Nguyen
- College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Nguyen-Tuong Ho
- College of Medicine, Taipei Medical University, Taipei, Taiwan.; Taipei Fertility Center, Taipei, Taiwan
| | | | - Loc Thai Ly
- Infertility Department, Hung Vuong Hospital, Ho Chi Minh City, Vietnam
| | | | | | - Chii-Ruey Tzeng
- College of Medicine, Taipei Medical University, Taipei, Taiwan.; Taipei Fertility Center, Taipei, Taiwan
| | - Van Toi Vo
- School of Biomedical Engineering, International University, Vietnam National University HCMC, Ho Chi Minh City, Vietnam
| | - Le-Giang Tran
- School of Biomedical Engineering, International University, Vietnam National University HCMC, Ho Chi Minh City, Vietnam..
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2
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Kim AE, Anderson-Bialis J, Citro L, Gracia CR. Patient satisfaction with telemedicine and in-person visits in reproductive endocrinology and infertility clinics. Reprod Biomed Online 2023; 47:103286. [PMID: 37619518 DOI: 10.1016/j.rbmo.2023.103286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
RESEARCH QUESTION Is patient satisfaction higher with telemedicine visits or in-person visits for an initial consultation in the ambulatory fertility setting? DESIGN A survey study of fertility patients who had an initial consultation visit between January 2018 and September 2022 was conducted using a nationally distributed survey. Patient satisfaction and other outcomes pertaining to patient experience were compared between telemedicine and in-person visits. RESULTS In total, 682 participants completed the survey nationwide; of these, 425 respondents had an in-person visit and 257 respondents had a telemedicine visit. Age, geographic region, race, education level, employment status, income level and marital status did not differ between the groups. Overall, 69.6% of participants were satisfied with telemedicine visits, with improvement in partner participation. More patients were satisfied with in-person visits compared with telemedicine visits (82.6% versus 69.6%, P<0.001), and more patients preferred in-person visits to telemedicine visits regardless of the type of appointment they had for their initial visit. In a subgroup analysis of patients seen during the coronavirus disease 2019 pandemic, patients who had telemedicine visits were younger, more likely to be White, more educated and had a higher income compared with patients who had in-person visits. CONCLUSIONS Previously, the impact of telemedicine in the fertility setting was largely unknown. This study demonstrated that the majority of patients were satisfied with health care through telemedicine visits. However, patients were more satisfied with in-person visits, and preferred in-person visits to telemedicine visits. Further studies are needed to help clarify the differences in patient satisfaction with visit type, and to assess the role of telemedicine in future fertility care.
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Affiliation(s)
- Anne E Kim
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | | | - Lauren Citro
- FertilityIQ, 2443 Fillmore Street #133, San Francisco, CA 94115, USA
| | - Clarisa R Gracia
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Lersten I, Fought A, Yannetsos C, Sheeder J, Roeca C. Patient perspectives of telehealth for fertility care: a national survey. J Assist Reprod Genet 2023:10.1007/s10815-023-02811-1. [PMID: 37115334 PMCID: PMC10141898 DOI: 10.1007/s10815-023-02811-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To evaluate patient satisfaction using telehealth for fertility care. METHODS Cross-sectional survey using the validated telehealth usability questionnaire (TUQ) distributed nationally via fertility advocacy groups of fertility patients aged ≥ 18 years with self-reported use of telehealth for care. Patient satisfaction of telehealth for fertility care as determined by the TUQ questionnaire. The survey also included questions about telehealth related to usefulness, ease of use, effectiveness, reliability, and the option for patients to add open-ended comments related to their experiences using telehealth for fertility care. RESULTS A total of 81 fertility patients completed the survey. Patients reported high rates of satisfaction (81.4%) with telehealth in areas of usefulness, ease of use, effectiveness, reliability, and satisfaction. However, many patients (60.5%) expressed a preference for in-person visits for their initial visit while the acceptability of telehealth increased for follow-up visits. Negative themes from respondent comments address that telehealth visits felt more impersonal and rushed. CONCLUSION Fertility patients reported high satisfaction using telehealth for care. Patients still preferred in-person visits for initial consultations. For follow-up visits, most respondents favored telehealth or had no preference. Incorporation of telehealth in fertility practices should continue though it may be helpful for patients to be given options for visit types.
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Affiliation(s)
- Ivy Lersten
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B-198, 4th Floor, Aurora, CO, USA.
- , Shady Grove Fertility, 8200 E Belleview Ave Suite 615-E, Greenwood Village, CO, USA.
| | - Angela Fought
- Center for Innovative Design and Analysis, University of Colorado School of Public Health, 13001 East 17th Place, 4th Floor West, Mail Stop B119, Aurora, CO, USA
| | - Christina Yannetsos
- Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue, 7th Floor, Aurora, CO, USA
| | - Jeanelle Sheeder
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B-198, 4th Floor, Aurora, CO, USA
| | - Cassandra Roeca
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, Mail Stop B-198, 4th Floor, Aurora, CO, USA
- , Shady Grove Fertility, 8200 E Belleview Ave Suite 615-E, Greenwood Village, CO, USA
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Satisfaction with Telemedicine for Cancer Pain Management: A Model of Care and Cross-Sectional Patient Satisfaction Study. Curr Oncol 2022; 29:5566-5578. [PMID: 36005177 PMCID: PMC9406413 DOI: 10.3390/curroncol29080439] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 01/19/2023] Open
Abstract
Background: Since cancer pain requires complex modalities of care, the proper strategy for addressing its telemedicine-based management should be better defined. This study aimed to trace a pathway for a progressive implementation of the telemedicine process for the treatment of pain in the setting of cancer patients. Methods: The features of the model were investigated to dissect the dropout from the telemedicine pathway. A cross-sectional patient satisfaction study was conducted. The degree of satisfaction was evaluated through a developed 22-item questionnaire (Likert scale 0−7). Results: A total of 375 video consultations for 164 patients (mean age 62.9 years) were performed through remote consultations for cancer pain management between March 2021 and February 2022. After the exclusion of 72 patients, 92 (56.1%) were included in the analysis. The dropout ratio was 8.7%. The number of visits and pharmacological therapies for neuropathic pain correlated with the risk for readmission (p < 0.05). Overall, the satisfaction was very high (mean > 5.5 for all items). Conclusion: Feedback from patients reflected high satisfaction rates with the care provided. A methodological approach based on the degree of satisfaction combined with the analysis of the pathways can help to implement the quality of a service provided through telemedicine. While not without limitations, our hybrid protocol can be useful for addressing cancer pain through a patient-centered approach.
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Brodeur TY, Grow D, Esfandiari N. Access to Fertility Care in Geographically Underserved Populations, a Second Look. Reprod Sci 2022; 29:1983-1987. [PMID: 35680726 PMCID: PMC9181892 DOI: 10.1007/s43032-022-00991-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022]
Abstract
Infertility has a prevalence of up to 16% worldwide and is on the rise in developed nations, largely due to pursuing childbearing at advanced reproductive ages. Advances in assisted reproductive technology have benefitted socioeconomically advantaged patients disproportionately. High costs of fertility care are largely responsible for this disparity; however, patients in rural areas also face barriers in accessing both gynecology and reproductive endocrinology subspecialty care. Here, focusing on the USA, we discuss fertility care in geographically underserved areas and low-resource settings, and the impact on reproductive outcomes. Increased innovation to improve patient access to fertility care such as assisted reproductive technology is critical for ensuring equity. Remote monitoring is frequently performed by fertility centers, but partnership with local gynecologists has also been demonstrated to be an effective assisted reproductive technology monitoring method. Telehealth is now in mainstream use and the continued application to reduce geographic barriers to infertility patients is imperative. Partnership between local gynecologists and reproductive endocrinology and infertility specialists may improve patient access to fertility care and provide the unique benefits of continuity and ongoing local social support.
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Affiliation(s)
- Tia Y Brodeur
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Vermont, 111 Colchester Avenue, Burlington, VT, 05401, USA
| | - Daniel Grow
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, University of Connecticut, Farmington, CT, USA
| | - Navid Esfandiari
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Reproductive Sciences, University of Vermont, 111 Colchester Avenue, Burlington, VT, 05401, USA.
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Anderson K, Coskun R, Jimenez P, Omurtag K. Satisfaction with new patient telehealth visits for reproductive endocrinology patients in the era of COVID-19. J Assist Reprod Genet 2022; 39:1571-1576. [PMID: 35713749 PMCID: PMC9204368 DOI: 10.1007/s10815-022-02539-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To study patient satisfaction with new patient telehealth visits in a reproductive endocrinology and infertility (REI) office. METHODS A cross-sectional study in a university-based fertility clinic was completed including all new patients seen via telehealth between March 1, 2021, and August 19, 2021. Primary outcomes were perceived patient satisfaction, access, and preferences to telehealth visits. RESULTS A total of 351 participants were contacted, 61.8% (n = 217) agreed to participate in the study, and 28.8% (n = 101) completed the survey. There were no significant differences in age, BMI, distance from clinic, or length of infertility with response to survey. Ninety-three percent of responders would use telehealth services again and were satisfied with the telehealth system. Telehealth improved access to healthcare for 88% and travel time for 96%. The median distance from clinic was 24 miles, and there was no significance difference in preference for telehealth visits over in person visits (p = 0.696). CONCLUSIONS In the era of COVID-19, healthcare implementation has dramatically changed with a drastic increase in telehealth services. Based on our survey, majority of patients were satisfied with telehealth visits and believed it saved travel time while improving access to REI care. Despite no differences in patient preference for in person versus telehealth depending on their distance from clinic, this is reassuring because patients are satisfied with telehealth for reasons other than distance from clinic.
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Affiliation(s)
- Kelsey Anderson
- Department of Obstetrics and Gynecology, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 3100, St. Louis, MO, 63108, USA.
| | - Reyan Coskun
- Washington University School of Medicine, St. Louis, MO, USA
| | - Patricia Jimenez
- Department of Obstetrics and Gynecology, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 3100, St. Louis, MO, 63108, USA
| | - Kenan Omurtag
- Department of Obstetrics and Gynecology, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 3100, St. Louis, MO, 63108, USA
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Vaughan DA, Yin SH, Shah JS, Gompers A, Hacker MR, Sakkas D, Domar A, Toth TL. Telemedicine for reproductive medicine: pandemic and beyond. J Assist Reprod Genet 2022; 39:327-329. [PMID: 35025052 PMCID: PMC8756755 DOI: 10.1007/s10815-021-02383-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/17/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- Denis A Vaughan
- Boston IVF - The Eugin Group, 130 2nd Ave, Waltham, MA, 02451, USA. .,Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Sophia H Yin
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jaimin S Shah
- Boston IVF - The Eugin Group, 130 2nd Ave, Waltham, MA, 02451, USA.,Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Annika Gompers
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Denny Sakkas
- Boston IVF - The Eugin Group, 130 2nd Ave, Waltham, MA, 02451, USA
| | - Alice Domar
- Boston IVF - The Eugin Group, 130 2nd Ave, Waltham, MA, 02451, USA.,Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Thomas L Toth
- Boston IVF - The Eugin Group, 130 2nd Ave, Waltham, MA, 02451, USA.,Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Cutting E, Catt S, Vollenhoven B, Mol BW, Horta F. The impact of COVID-19 mitigation measures on fertility patients and clinics around the world. Reprod Biomed Online 2021; 44:755-763. [PMID: 35190253 PMCID: PMC8712431 DOI: 10.1016/j.rbmo.2021.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/02/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Elizabeth Cutting
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia.
| | - Sally Catt
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia
| | - Beverley Vollenhoven
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
| | - Ben W Mol
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia
| | - Fabrizzio Horta
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
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