<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732022000200172</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v38i2.13152</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Terá a teleconsulta impacto na morbimortalidade dos doentes com patologias crónicas?]]></article-title>
<article-title xml:lang="en"><![CDATA[Does teleconsultation have an impact on the morbidity and mortality of patients with chronic diseases?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domingues]]></surname>
<given-names><![CDATA[Inês Gonçalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Ana Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[Inês Oliveira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Ricardo Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caetano]]></surname>
<given-names><![CDATA[José Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonte]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Cávado I USF do Minho ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Minho School of Medicine Life and Health Sciences Research Institute]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Government Associate Laboratory  ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>04</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>2</numero>
<fpage>172</fpage>
<lpage>181</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732022000200172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732022000200172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732022000200172&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Objetivo:  Determinar se existem diferenças entre o acompanhamento por teleconsulta e o acompanhamento habitual nos doentes com patologias crónicas, nos cuidados de saúde primários e secundários, no que concerne à redução da morbilidade e mortalidade.  Fontes dos dados:  MEDLINE/PubMed, NHS Evidence, The Cochrane Library e Turning Research Into Practice.  Métodos:  Pesquisa de estudos observacionais, ensaios clínicos e revisões sistemáticas nas línguas portuguesa e inglesa, publicados entre janeiro de 2000 e agosto de 2020, utilizando os termos MeSH Chronic Disease, Telemedicine, Remote Consultation, Primary Health Care e General Practice. Para avaliac&#807;a&#771;o dos ni&#769;veis de evide&#770;ncia e da forc&#807;a de recomendac&#807;a&#771;o foi aplicada a escala Strength of Recommendation Taxonomy (SORT), da American Family Physician.  Resultados:  Obtiveram-se 260 estudos, dos quais apenas oito cumpriram os critérios de inclusão. Cinco dos estudos revelaram benefício significativo na morbimortalidade com o recurso a teleconsulta, face aos cuidados habituais, nomeadamente: melhoria da qualidade de vida e diminuição do número de internamentos em doentes com múltiplas comorbilidades; diminuição de sintomas álgicos e depressão associados a dor músculo-esquelética crónica; diminuição da hospitalização e mortalidade por todas as causas e diminuição de recurso a cuidados de saúde adicionais no caso da insuficiência cardíaca. Dois estudos demonstraram resultados sobreponíveis entre os doentes teleconsultados e os doentes sob cuidados habituais, relativamente ao número de exacerbações e recurso a cuidados de saúde adicionais em doentes asmáticos, número e duração de reinternamento por doença pulmonar obstrutiva crónica ou insuficiência cardíaca e na mortalidade e recursos de cuidados de saúde adicionais nos doentes com múltiplas comorbilidades.  Conclusão:  Esta revisão demonstrou não haver um consenso claro quanto aos resultados dos indicadores de morbimortalidade em utentes com patologias crónicas, acompanhados por teleconsulta. Ainda assim, a maioria dos estudos demonstrou benefício do uso de teleconsulta nos indicadores de morbimortalidade dos doentes acompanhados por teleconsulta relativamente aos doentes acompanhados por método habitual. Embora não consonantes, os estudos encontrados demonstraram resultados pelo menos sobreponíveis, e não inferiores, na utilização da teleconsulta quando comparada com o acompanhamento habitual dos doentes. E, considerando a qualidade dos estudos encontrados, são necessários mais estudos neste âmbito para aumentar a robustez dos resultados encontrados e permitir a generalização à prática clínica diária.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objectives:  To establish if there are differences between the use of teleconsultation and the usual care in patients with one or more chronic diseases, followed in primary or secondary healthcare, in association with the reduction of morbidity and mortality.  Data sources:  MEDLINE/PubMed, NHS Evidence, The Cochrane Library e Turning Research Into Practice.  Methods:  Search of observational studies, clinical trials, systematic reviews, and meta-analyses in Portuguese and English, published between January 2000 and August 2020 with the MeSH terms &#8216;Chronic Disease&#8217;, &#8216;Telemedicine&#8217;, &#8216;Remote Consultation&#8217;, &#8216;Primary Health Care&#8217; and &#8216;General Practice&#8217;. To assess the evidence levels and recommendation importance it was used the Strength of Recommendation Taxonomy (SORT) scale of the American Family Physician.  Results:  Two hundred and sixty articles were obtained, of which only eight met the inclusion criteria. Five of the studies showed significant benefits in morbidity and mortality criteria, with the use of teleconsultation versus the use of usual care, such as: improvement in quality of life and a decrease in the number of hospitalizations of patients with multiple comorbidities; minimization of aching symptoms and depression, associated with chronic musculoskeletal pain; decreasing of hospitalization and mortality from all causes and reduction of the use of additional health care support in case of heart failure. Two studies showed the results between patients with access to teleconsultation and patients with usual care, in relation to the number of exacerbations, the use of additional health care assistance in asthmatic patients; number and duration of re-hospitalization in patients with chronic obstructive pulmonary disease or heart failure and concerning mortality and use of additional health care support by patients with multiple comorbidities.  Conclusion:  This revision showed that there is no obvious consensus regarding the results of morbidity and mortality indication criteria, in patients with chronic diseases, supported by teleconsultation. Nevertheless, the majority of the studies manifested the benefit of the use of teleconsultation in such criteria, compared to the patients supported by the usual consultation methods. Although not concordant, regarded studies demonstrated results at least overlapping, and not inferior, in the use of telemedicine when compared to the usual follow-up of patients. Even so, regarding the quality of the considered studies, there are needed more studies in this area to increase the viability of the results demonstrated, and allow the consequent generalization to the daily and normalized clinical practice.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Teleconsulta]]></kwd>
<kwd lng="pt"><![CDATA[Doença crónica]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados de saúde primários]]></kwd>
<kwd lng="pt"><![CDATA[Morbilidade e mortalidade]]></kwd>
<kwd lng="en"><![CDATA[Teleconsultation]]></kwd>
<kwd lng="en"><![CDATA[Chronic disease]]></kwd>
<kwd lng="en"><![CDATA[Primary health care]]></kwd>
<kwd lng="en"><![CDATA[Morbidity and mortality]]></kwd>
</kwd-group>
</article-meta>
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