Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis

2016 ◽  
Vol 31 (5) ◽  
pp. 625-638 ◽  
Author(s):  
Michelle A Cottrell ◽  
Olivia A Galea ◽  
Shaun P O’Leary ◽  
Anne J Hill ◽  
Trevor G Russell
Keyword(s):  
Usual Care ◽  
Physical Function ◽  
Real Time ◽  
Meta Analysis ◽  
Healthcare Delivery ◽  
Eligibility Criteria ◽  
Musculoskeletal Conditions ◽  
Face To Face ◽  
Conventional Methods ◽  
Mean Differences

Objective: To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population. Data sources: Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions. Review methods: Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black ‘Checklist for Measuring Quality’ tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI). Results: Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI −0.10–0.37, I2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI −0.27–1.60, I2=96%) following intervention. Conclusions: Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.

Comparative Efficacy of Seven Exercise interventions for Symptoms of depression in college students: a network of meta-analysis

2019 ◽  
Author(s):  
Shengyu Guo ◽  
Fuying Li ◽  
Yan Yang ◽  
Ling Chen
Keyword(s):  
College Students ◽  
Depressive Symptoms ◽  
Usual Care ◽  
Tai Chi ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Exercise Interventions ◽  
Symptoms Of Depression ◽  
Depressed College Students

Abstract Background Depression among college students is common, exercise interventions are valued as one of the most widely prescribed interventions for depressed college students, however, it is especially difficult for university administrators to determine which exercise intervention is most effective, and efficacy of exercise interventions among depressed college students have not been evaluated. Objectives To systematically review and compare the efficacy of Seven Exercise interventions for Symptoms of depression in college students. Method A network of meta-analysis was conducted to fill the objectives. PubMed, Embase databases, and two Chinese language electronic databases WANFANG and CNKI were searched for the related articles. Eligibility criteria Randomized controlled trials comparing the efficacy of Seven Exercise interventions with usual care of college students with depression were included in the review. Main outcomes The Primary outcome of the present study were standardized mean difference(SMD) and the mean change of depressive symptoms. Results 14 trials were identified, including 2010 depressed college students. The result of direct meta-analysis of this review indicated exercise interventions overall had a significantly lower mean depression scores (SMD=-1.13) when compared with usual care. The result of NMA indicated when comparing with badminton intervention, yoga(SMD=-7.7, 95%CI -14 to -0.93) and tai chi (SMD=-9.4, 95%CI -16 to -2.7) can significantly decrease depression scores of the depressed college students. The rank of seven exercise interventions with respect to efficiently decrease symptom of depressed undergraduates was Tai chi > Yoga > Volleyball > Dance > Run> Basketball> Badminton, respectively. Conclusions Tai chi exhibited the highest probability that became the most efficacy intervention among the comparions, and Yoga showed the second most effectiveness to alleviate depressive symptoms of depressed college students, and dance ranks the third, followed by run, volleyball, basketball, badminton respectively.

scholarly journals Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Ditte Hoffmann ◽  
Charlotte Ulrikka Rask ◽  
Erik Hedman-Lagerlöf ◽  
Trine Eilenberg ◽  
Lisbeth Frostholm
Keyword(s):  
Health Anxiety ◽  
Diagnostic Delay ◽  
Accurate Method ◽  
Diagnostic Interview ◽  
Self Report ◽  
Eligibility Criteria ◽  
Recruitment Methods ◽  
Face To Face ◽  
Symptom Profile ◽  
Mean Differences

Background Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. Aims This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. Method Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. Results In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile. Conclusions Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics. Declaration of interest None.

scholarly journals Comparing the Effects of Docosahexaenoic and Eicosapentaenoic Acids on Inflammation Markers Using Pairwise and Network Meta-Analyses of Randomized Controlled Trials

2020 ◽  
Author(s):  
Cécile Vors ◽  
Janie Allaire ◽  
Sonia Blanco Mejia ◽  
Tauseef A Khan ◽  
John L Sievenpiper ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Necrosis Factor Alpha ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Tnf Α ◽  
Mean Differences ◽  
Meta Analyses

ABSTRACT Recent data from randomized clinical trials (RCTs) suggest that DHA may have stronger anti-inflammatory effects than EPA. This body of evidence has not yet been quantitatively reviewed. The aim of this study was to compare the effect of DHA and EPA on several markers of systemic inflammation by pairwise and network meta-analyses of RCTs. MEDLINE, EMBASE, and The Cochrane Library were searched through to September 2019. We included RCTs of ≥7 d on adults regardless of health status that directly compared the effects of DHA with EPA and RCTs of indirect comparisons, in which the effects of DHA or EPA were compared individually to a control fatty acid. Differences in circulating concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and adiponectin were the primary outcome measures. Data were pooled by pairwise and network meta-analysis and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic) in the pairwise meta-analysis. Inconsistency and transitivity were evaluated in the network meta-analysis. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Eligibility criteria were met by 5 RCTs (N = 411) for the pairwise meta-analysis and 20 RCTs (N = 1231) for the network meta-analysis. In the pairwise meta-analysis, DHA and EPA had similar effects on plasma CRP [MDDHA versus EPA = 0.14 mg/L (95% CI: –0.57, 0.85); I2 = 61%], IL-6 [MDDHA versus EPA = 0.10 pg/mL (–0.15, 0.34); I2 = 40%], and TNF-α [MDDHA versus EPA = –0.10 pg/mL (–0.37, 0.18); I2 = 40%]. In the network meta-analysis, the effects of DHA and EPA on plasma CRP [MDDHA versus EPA = –0.33 mg/L (–0.75, 0.10)], IL-6 [MDDHA versus EPA = 0.09 pg/mL (–0.12, 0.30)], and TNF-α [MDDHA versus EPA = –0.02 pg/mL (–0.25, 0.20)] were also similar. DHA and EPA had similar effects on plasma adiponectin in the network meta-analysis. Results from pairwise and network meta-analyses suggest that supplementation with either DHA or EPA does not differentially modify systemic markers of subclinical inflammation.

scholarly journals The Impact of Face Masks on Performance and Physiological Outcomes during Exercise: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Keely A. Shaw ◽  
Gordon A. Zello ◽  
Scotty J. Butcher ◽  
Jong Bum Ko ◽  
Leandy Bertrand ◽  
...  
Keyword(s):  
Systematic Review ◽  
Exercise Performance ◽  
Perceived Exertion ◽  
Meta Analysis ◽  
Mask Condition ◽  
Eligibility Criteria ◽  
Physiological Variables ◽  
Mean Differences ◽  
End Tidal ◽  
The Impact

AbstractFace masks are promoted for preventing spread of viruses; however, wearing a mask during exercise might increase CO2 rebreathing, decrease arterial oxygenation, and decrease exercise performance. A systematic review and meta-analysis was conducted on the impact of wearing a mask during exercise. Data sources included SPORTDiscus, PubMed, and Medline. Eligibility criteria included all study designs comparing surgical, N95, or cloth masks to a no mask condition during any type of exercise where exercise performance and/or physiological parameters were evaluated. Healthy and clinical participants were included. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals were calculated and pooled effects assessed. Twenty-two studies involving 1,573 participants (620 females, 953 males) were included. Surgical, or N95 masks did not impact exercise performance (SMD −0.05 [-0.16,0.07] and −0.16 [-0.54,0.22], respectively) but increased ratings of perceived exertion (RPE) (SMD 0.33 [0.09,0.58] and 0.61 [0.23,0.99]) and dyspnea (SMD 0.6 [0.3,0.9] for all masks). End-tidal CO2 (MD 3.3 [1.0, 5.6] and 3.7 [3.0,4.4] mmHg), and heart rate (MD 2 [0,4] beats/min with N95 masks) slightly increased. Face masks can be worn during exercise with no influences on performance and minimal impacts on physiological variables.PROSPERO RegistrationCRD42020224988Novelty PointsFace masks can be worn during exercise with no impacts on performance and minimal impacts on physiological variables.

scholarly journals Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047273
Author(s):  
Mei-Ying Kwan ◽  
Kit-Lun Yick ◽  
Joanne Yip ◽  
Chi-Yung Tse
Keyword(s):  
Systematic Review ◽  
Hallux Valgus ◽  
Outcome Measurement ◽  
Meta Analysis ◽  
Outcome Data ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Systematic Analysis ◽  
Registration Number ◽  
Mean Differences

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

scholarly journals Effectiveness of the Internet-based Versus Face-to-Face Interaction on Reduction of Tobacco use among Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Rajesh Kumar ◽  
Ravi Kant ◽  
Poonam Yadav ◽  
Tamar Rodney ◽  
Mukesh Bairwa
Keyword(s):  
Tobacco Use ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Internet ◽  
Forest Plot ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Face To Face ◽  
Registration Number

Abstract Literature reported the effectiveness of internet-based interventions over face-to-face interaction on tobacco quitting; however, limited sample size reinforces to integrate and analyze these studies' findings to reach a single conclusion. Therefore, we evaluated the effectiveness of the internet-based versus face-to-face interventions on reducing tobacco use with a systematic search through various electronic databases such as Medline, PsychInfo, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ResearchGate, Google Scholar, and Academia. Reference lists of the eligible articles were also screened. Full-text articles were included as per eligibility criteria (PICO framework). A total of 13 studies were selected for meta-analysis, with 3852 and 3908 participants in intervention and control groups. Forest plot favours the intervention group at one month follow up for tobacco quitting (OR: 2.37, CI: 1.86–3.02, P-0.00001, I2 = 0%), at three months (OR: 1.88, CI: 1.48–2.40, P-0.00001, I2 = 42%) at six months (OR: 2.02, CI: 1.64–2.50, P-0.00001, I2 = 38%) and at 1 year of follow-up (OR: 1.43, CI: 1.18–1.74, P-0.00001, I2 = 36%). Internet and web-based interventions are highly useful in tobacco quitting at one month, three months, six months, and one year of follow-up compared to face-to-face interaction or no intervention, although the evidence level was moderate.Prospero Registration number- CRD42020214306

Web-based decision aids to support breast cancer screening decisions: systematic review and meta-analysis

2020 ◽  
Vol 9 (14) ◽  
pp. 985-1002
Author(s):  
Lin Yu ◽  
Ping Li ◽  
Shu Yang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Cancer Screening ◽  
Usual Care ◽  
Breast Cancer Screening ◽  
Meta Analysis ◽  
Decision Aids ◽  
Web Based ◽  
Mean Differences

Aim: Breast cancer is a leading cause of cancer among women. Because guidelines on screening for breast cancer for certain ages are controversial, many experts advocate the use of shared decision making (SDM) using validated decision aids (DAs). Recent studies have concluded that DAs are beneficial; however, the results have great heterogeneity. Therefore, further studies are needed to improve understanding of these tools. Objective: This systematic review and meta-analysis aimed to investigate the impact of using web-based DAs in women aged 50 years and below facing the decision to be screened for breast cancer in comparison with usual care. Methods: PubMed, Web of Science, Embase and the Cochrane CENTRAL databases were searched up to February 2020 for studies assessing web-based DAs for women making a breast cancer screening decision and reported quality of decision-making outcomes. Using a random-effects model or a fixed-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD) and relative risks (RR). Results: Of 1097 unique citations, three randomized controlled trials and two before–after studies met the study eligibility criteria. Compared with usual care, web-based DAs increased knowledge (SMD = 0.69; 95% CI: 0.57–0.80; p < 0.00001), reduced decision conflict and increased the proportion of women who made an informed choice (RR = 1.86; 95% CI: 1.38 to 2.50; p < 0.0001), but did not change the intention of women deciding to be screened or affect decision regret. Conclusion: This analysis showed the positive effect of web-based DAs on patient-centered outcomes in breast cancer screening. In the future, more internet devices and free or larger discount WI-FI should be established to ensure more women can benefit from this effective tool.

scholarly journals Higher adherence to Mediterranean Diet is associated with improved semen parameters: A systematic review and meta-analysis of observational studies

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Jakub Morze ◽  
Anna Danielewicz ◽  
Katarzyna Przybylowicz
Keyword(s):  
Mediterranean Diet ◽  
Observational Studies ◽  
Semen Quality ◽  
Sperm Count ◽  
Meta Analysis ◽  
Quality Parameters ◽  
Semen Parameters ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Mean Differences

AbstractSemen quality is a key indicator of male fecundity and therefore is closely related to male fertility. In recent decades a significant decrease of semen parameters was observed worldwide. Except for environmental pollution, low physical activity, body weight and comorbidities, unhealthy diet was linked to semen quality decline. Mediterranean Diet (MedDiet) due to its anti-oxidative and anti-inflammatory properties, is considered as beneficial for semen. However, results of existing studies are inconclusive. The aim of this review was to pool associations between adherence to the MedDiet and semen quality parameters in observational studies. Electronic databases including PubMed, Embase and Scopus were searched until April 2019 with no restriction to language or time. Studies were eligible for inclusion if they filled following criteria: (1) observational design (retrospective or prospective), (2) adherence to MedDiet assessed using score or data-driven method and (3) semen quality parameters (total motility, progressive motility, total count, concentration or volume) as outcomes. Mean differences or odds ratios of abnormal semen parameters between the highest and lowest quintiles of MedDiet were converted to standardized mean differences (SMD). Random effects models with inverse variance method were used to pool differences. Heterogeneity was assessed using the Cochrane Q test and I2 statistic with value > 50% indicating substantial heterogeneity. Five cross-sectional studies extracted from 840 articles, met the eligibility criteria and were included in the meta-analysis. Higher adherence to MedDiet compared to lower adherence was associated with increased total (SMD = 0.59 95%CI: 0.12–1.06, I2 = 80%, pheterogenity < 0.01, n = 4) and progressive (SMD = 0.53 95%CI: 0.16–0.91, I2 = 0%, pheterogenity = 0.94, n = 2) sperm motility. No associations were observed between adherence to MedDiet and total sperm count (SMD = 0.14 95%CI: -0.20–0.48, I2 = 70%, pheterogenity < 0.01, n = 5), concentration (SMD = 0.22 95%CI: -0.04–0.47, I2 = 48%, pheterogenity = 0.10, n = 5), volume (SMD = 0.02 95%CI: -0.20–0.25, I2 = 21%, pheterogenity = 0.28, n = 5), as well as morphology (SMD = -0.10 95%CI: -0.36–0.16, I2 = 38%, pheterogenity = 0.18, n = 4). The results suggest that higher adherence to the MedDiet may have a protective effect on semen quality, probably by increased intake of antioxidant-rich products. Limitations of findings include substantial between-study heterogeneity and use of cross-sectional design. Beneficial effects of the MedDiet on semen quality have to be confirmed in further prospective studies.

scholarly journals Effects of exercise on kidney and physical function in patients with non-dialysis chronic kidney disease: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Keisuke Nakamura ◽  
Tomohiro Sasaki ◽  
Shuhei Yamamoto ◽  
Hiroto Hayashi ◽  
Shinji Ako ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Exercise Training ◽  
Usual Care ◽  
Physical Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Risk Of Mortality ◽  
Walking Capacity ◽  
Physical Functions

Abstract Patients with non-dialysis chronic kidney disease (CKD) are at greater risk of early mortality and decreased physical function with an advance in the stage of CKD. However, the effect of exercise in these patients is unclear. This meta-analysis aimed to determine the effects of physical exercise training on the risk of mortality, kidney and physical functions, and adverse events in patients with non-dialysis CKD. The meta-analysis conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the Cochrane Handbook recommendations. On 16 August 2019, the PubMed, CINAHL, Cochrane Library databases, and Embase were electronically searched, with no restrictions for date/time, language, document type, or publication status, for eligible randomized controlled trials (RCTs) investigating the effects of exercise on mortality and kidney and physical function in patients with non-dialysis CKD. Eighteen trials (28 records), including 848 patients, were analyzed. The effects of exercise on all-cause mortality and estimated glomerular filtration rate were not significantly different from that of usual care. Exercise training improved peak/maximum oxygen consumption compared to usual care. Regular exercise improves physical and walking capacity for patients with non-dialysis CKD. Effect on leg muscle strength was unclear.

scholarly journals Remote Consultations Versus Standard Face-to-Face Appointments for Liver Transplant Patients in Routine Hospital Care: Feasibility Randomized Controlled Trial of myVideoClinic

10.2196/19232 ◽  
2021 ◽  
Vol 23 (9) ◽  
pp. e19232
Author(s):  
Sarah Damery ◽  
Janet Jones ◽  
Elaine O'Connell Francischetto ◽  
Kate Jolly ◽  
Richard Lilford ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Liver Transplant ◽  
Usual Care ◽  
Real Time ◽  
Process Evaluation ◽  
Face To Face ◽  
Transplant Patients ◽  
Qualitative Process Evaluation ◽  
Remote Consultations

Background Using technology to reduce the pressure on the National Health Service (NHS) in England and Wales is a key government target, and the NHS Long-Term Plan outlines a strategy for digitally enabled outpatient care to become mainstream by 2024. In 2020, the COVID-19 response saw the widespread introduction of remote consultations for patient follow-up, regardless of individual preferences. Despite this rapid change, there may be enduring barriers to the effective implementation of remote appointments into routine practice once the unique drivers for change during the COVID-19 pandemic no longer apply, to which pre-COVID implementation studies can offer important insights. Objective This study aims to evaluate the feasibility of using real-time remote consultations between patients and secondary care physicians for routine patient follow-up at a large hospital in the United Kingdom and to assess whether patient satisfaction differs between intervention and usual care patients. Methods Clinically stable liver transplant patients were randomized to real-time remote consultations in which their hospital physician used secure videoconferencing software (intervention) or standard face-to-face appointments (usual care). Participants were asked to complete postappointment questionnaires over 12 months. Data were analyzed on an intention-to-treat basis. The primary outcome was the difference in scores between baseline and study end by patient group for the three domains of patient satisfaction (assessed using the Visit-Specific Satisfaction Instrument). An embedded qualitative process evaluation used interviews to assess patient and staff experiences. Results Of the 54 patients who were randomized, 29 (54%) received remote consultations, and 25 (46%) received usual care (recruitment rate: 54/203, 26.6%). The crossover between study arms was high (13/29, 45%). A total of 129 appointments were completed, with 63.6% (82/129) of the questionnaires being returned. Patient satisfaction at 12 months increased in both the intervention (25 points) and usual care (14 points) groups. The within-group analysis showed that the increases were significant for both intervention (P<.001) and usual care (P=.02) patients; however, the between-group difference was not significant after controlling for baseline scores (P=.10). The qualitative process evaluation showed that—according to patients—remote consultations saved time and money, were less burdensome, and caused fewer negative impacts on health. Technical problems with the software were common, and only 17% (5/29) of patients received all appointments over video. Both consultants and patients saw remote consultations as positive and beneficial. Conclusions Using technology to conduct routine follow-up appointments remotely may ease some of the resource and infrastructure challenges faced by the UK NHS and free up clinic space for patients who must be seen face-to-face. Our findings regarding the advantages and challenges of using remote consultations for routine follow-ups of liver transplant patients have important implications for service organization and delivery in the postpandemic NHS. Trial Registration ISRCTN Registry 14093266; https://www.isrctn.com/ISRCTN14093266 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-018-2953-4

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