A Systematic Review Identifying Adverse Health Outcomes and Mortality Rates Associated with Telehealth


  • Fidelia Cascini, MD, PhD Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy https://orcid.org/0000-0001-6499-0734
  • Ana Pantovic, MSc Faculty of Biology, University of Belgrade, Belgrade, Serbia https://orcid.org/0000-0001-5694-2644
  • Yazan A. Al-Ajlouni, MPhil New York Medical College School of Medicine, Valhalla, New York, USA https://orcid.org/0000-0002-1718-4964
  • Omar Al Ta’ani, MD University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  • Giovanna Failla, MD Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy https://orcid.org/0000-0002-1349-3129
  • Andriy Melnyk, MD Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
  • Paul Barach, BSC, MD, MPH, Maj Thomas Jefferson College of Population Health, Philadelphia, Pennsylvania, USA https://orcid.org/0000-0002-7906-698X
  • Walter Ricciardi, MD, MPH, MSc, PhD Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy




evidence-based practice, literature, PRISMA, telehealth, telemedicine, telecare


Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions.

Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative synthesis. Of the 78 included studies 8 were included in the quantitative synthesis resulting in 2 meta-analyses. The results of the meta-analysis suggest that monitoring patients using telehealth techniques is associated with 40% lower mortality risks among patients suffering from heart failure, compared to those who received traditional care. The results of the random-effects meta-analysis showed the pooled relative risk of mortality to be 0.60, indicating that patients that underwent telemonitoring had a lower mortality risk compared with the patients that underwent usual care. Among patients with heart implants, patients who received telemonitoring had a 35% lower mortality risk compared to patients receiving traditional care.

Conclusions: While RCTs of telehealth interventions demonstrate enhanced patient outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.


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How to Cite

Cascini, F., Pantovic, A., Al-Ajlouni, Y., Al Ta’ani, O., Failla, G., Melnyk, A., Barach, P., & Ricciardi, W. (2023). A Systematic Review Identifying Adverse Health Outcomes and Mortality Rates Associated with Telehealth. Telehealth and Medicine Today, 8(3). https://doi.org/10.30953/thmt.v8.415



Narrative/Systematic Reviews/Meta-Analysis