Abstract
BACKGROUND: There is a lack of consensus on the effectiveness of audio-based care to manage chronic conditions. This knowledge gap has implications for health policy decisions and for health equity, as underserved populations are more likely to access care by telephone. OBJECTIVES: We compared the effectiveness of audio-based care to usual care for managing chronic conditions (except diabetes). DESIGN: We used systematic review methods to synthesize available evidence. STUDIES: We searched for English-language articles reporting on randomized controlled trials (RCTs) of adults diagnosed with a chronic condition published since 2012. OUTCOMES: We abstracted data on clinical outcomes, patient-reported health and quality of life, health care access and utilization, care quality and experience, and patient safety. RESULTS: We included 40 RCTs evaluating audio-based care for a variety of chronic conditions, including cancer, heart failure, neurological disease, respiratory disease, musculoskeletal conditions, kidney disease, and others. There was significant heterogeneity across conditions and interventions. We generally found low to very low certainty of evidence of comparable effectiveness in the use of audio-based care to replace other care. Audio care as a supplement exhibited greater effectiveness in some outcomes, with generally low to very low certainty of evidence for most outcomes but moderate certainty for 2 groups of study outcomes. CONCLUSIONS: More research is needed to identify the conditions, populations, and intervention design combinations that improve outcomes and to determine when audio-based care can effectively replace other synchronous care.