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Review Article

Utilization of telehealth services in low- and middle-income countries amid the COVID-19 pandemic: a narrative summary

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Article: 2179163 | Received 07 Sep 2022, Accepted 07 Feb 2023, Published online: 20 Feb 2023

References

  • Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, evaluation, and treatment of coronavirus (COVID-19). Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC; 2022.
  • Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11:e045343. Epub 2021 Mar 18. PubMed PMID: 33727273; PubMed Central PMCID: PMC7969768.
  • World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020. WHO reference number: WHO/2019-nCoV/EHS_continuity/survey/. Geneva: World Health Organization, 2020; 2020.
  • Wijesooriya NR, Mishra V, Brand PLP, Rubin BK. COVID-19 and telehealth, education, and research adaptations. Paediatr Respir Rev. 2020;35:38–11. Epub 2020 Jun13. PubMed PMID: 32653468; PubMed Central PMCID: PMC7301824.
  • Katzow MW, Steinway C, Jan S. Telemedicine and health disparities during COVID-19. Pediatrics. 2020;146. DOI:10.1542/peds.2020-1586. Epub 2020 Aug 05. PubMed PMID: 32747592.
  • Wosik J, Fudim M, Cameron B, Gellad ZF, Cho A, Phinney D, et al. Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Inform Assoc. 2020;27:957–962. Epub 2020 Apr 21. PubMed PMID: 32311034; PubMed Central PMCID: PMC7188147.
  • LeRouge C, Garfield MJ. Crossing the telemedicine chasm: have the U.S. barriers to widespread adoption of telemedicine been significantly reduced? Int J Environ Res Public Health. 2013;10:6472–6484. Epub 2013 11 28. PubMed PMID: 24287864; PubMed Central PMCID: PMC3881125.
  • Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020;20:1193. Epub 2020 Aug 03. PubMed PMID: 32738884; PubMed Central PMCID: PMC7395209.
  • Kichloo A, Albosta M, Dettloff K, Wani F, El-Amir Z, Singh J, et al. Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Fam Med Community Health. 2020;8:e000530. Epub 2020 Aug 21. PubMed PMID: 32816942; PubMed Central PMCID: PMC7437610.
  • Lewis T, Synowiec C, Lagomarsino G, Schweitzer J. E-health in low- and middle-income countries: findings from the center for health market innovations. Bull World Health Organ. 2012;90:332–340. Epub 2012 May 17. PubMed PMID: 22589566; PubMed Central PMCID: PMC3341696.
  • Combi C, Pozzani G, Pozzi G. Telemedicine for developing countries. A survey and some design issues. Appl Clin Inform. 2016;7:1025–1050. Epub 2016 Nov 03. PubMed PMID: 27803948; PubMed Central PMCID: PMC5228142.
  • Bagayoko CO, Traoré D, Thevoz L, Diabaté S, Pecoul D, Niang M, et al. Medical and economic benefits of telehealth in low- and middle-income countries: results of a study in four district hospitals in Mali. BMC Health Serv Res. 2014;14:S9. Epub 2014 August 01. PubMed PMID: 25080312; PubMed Central PMCID: PMC4108933.
  • Totten AM, Womack DM, Eden KB, McDonagh MS, Griffin JC, Grusing S, et al. AHRQ comparative effectiveness technical briefs. Telehealth: mapping the evidence for patient outcomes from systematic reviews. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.
  • World Bank. World Bank Country and Lending Groups, Country Classification. 2021. [cited 2021 Oct 18]. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
  • Moyo J, Madziyire G. Use of telemedicine in obstetrics and gynaecology in Zimbabwe during a lockdown period. Pan Afr Med J. 2020;35:89. Epub 2021 Feb 25. PubMed PMID: 33623613; PubMed Central PMCID: PMC7875788.
  • Ashry AH, Alsawy MF. Doctor-patient distancing: an early experience of telemedicine for postoperative neurosurgical care in the time of COVID-19. Egypt J Neurol Psychiatr Neurosurg. 2020;56:80. Epub 2020 Aug 25. PubMed PMID: 32834718; PubMed Central PMCID: PMC7376313.
  • Todaro V, Giuliano L, Cicero CE, Spina L, Colli C, Cuellar S, et al. Prevalence of epilepsy in the rural area of the Bolivian Gran Chaco: usefulness of telemedicine and impact of awareness campaigns. Epilepsia Open. 2022. DOI:10.1002/epi4.12677. Epub 2022 Dec 02. PubMed PMID: 36461651.
  • Semprino M, Fasulo L, Fortini S, Martorell Molina CI, González L, Ramos PA, et al. Telemedicine, drug-resistant epilepsy, and ketogenic dietary therapies: a patient survey of a pediatric remote-care program during the COVID-19 pandemic. Epilepsy Behav. 2020;112:107493. Epub 2020 Nov 14. PubMed PMID: 33181913; PubMed Central PMCID: PMC7532773.
  • Sahu D, Shah D, Joshi M, Shaikh S, Gaikwad P, Shyam A. Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium. J Shoulder Elbow Surg. 2021. DOI:10.1016/j.jse.2021.06.017. Epub 2021 Aug 06. PubMed PMID: 34352402.
  • Ramnath VR, Hill L, Schultz J, Mandel J, Smith A, Morris T, et al. An in-person and telemedicine “hybrid” system to improve cross-border critical care in COVID-19. Ann Glob Health. 2021;87:1. Epub 2021 Jan 29. PubMed PMID: 33505860; PubMed Central PMCID: PMC7792461 regard to this manuscript. Regarding Dr. Malhotra: his lab is funded by the National Institutes of Health, he has received income related to medical education from Merck and Livanova, unrelated to the subject matter of this manuscript. ResMed provided a philanthropic donation to UC San Diego.
  • Kumari J, Jat KR, Kabra SK. Role of telemedicine in follow-up care of children with respiratory illnesses at a tertiary care hospital - an ambispective observational study. Indian J Pediatr. 2021;88:974–978. Epub 2021 Jan 05. PubMed PMID: 33394296; PubMed Central PMCID: PMC7780214.
  • Kumar S, Kumar A, Kumar M, Kumar A, Arora R, Sehrawat R. Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: a preliminary study. J Clin Orthop Trauma. 2020;11:S704–s10. Epub 2020 Aug 25. PubMed PMID: 32837105; PubMed Central PMCID: PMC7395587.
  • Li X, Hu J, Yao Y, Zuo C, Wang Z, Li X, et al. Evaluation of pharmacist-led telemedicine medication management for hypertension established patients during COVID-19 pandemic: a pilot study. Front Public Health. 2022;10:1091484. Epub 2022 Dec 16. PubMed PMID: 36589937; PubMed Central PMCID: PMC9800920.
  • Harindhanavudhi T, Areevut C, Sahakitrungruang T, Tharavanij T, Kietdumrongwong P, Ngimruksa O, et al. Implementation of diabetes care and educational program via telemedicine in patients with COVID-19 in home isolation in Thailand: a real-worldexperience. J Diabetes Investig. 2022;13:1448–1457. Epub 2022 Apr 25. PubMed PMID: 35394118; PubMed Central PMCID: PMC9114836.
  • Ghosh R, Healy A, Prabhune A, Mallavaram A, Raju S, Chockalingam N. Provision of rehabilitation and assistive technology services in a low resource setting during the COVID-19 pandemic and introduction of telehealth: service users’ and providers’ perspectives. Assist Technol. 2022:1–7. DOI:10.1080/10400435.2022.2095582. Epub 2022 Jul 20. PubMed PMID: 35857654.
  • Kwok JYY, Lee JJ, Choi EPH, Chau PH, Auyeung M. Stay mindfully active during the coronavirus pandemic: a feasibility study of mHealth-delivered mindfulness yoga program for people with Parkinson’s disease. BMC Complement Med Ther. 2022;22:37. Epub 2022 Feb 07. PubMed PMID: 35130894; PubMed Central PMCID: PMC8818838.
  • Yin W, Liu Y, Hu H, Sun J, Liu Y, Wang Z. Telemedicine management of type 2 diabetes mellitus in obese and overweight young and middle-aged patients during COVID-19 outbreak: a single-center, prospective, randomized control study. PLoS ONE. 2022;17:e0275251. Epub 2022 Sept 29. PubMed PMID: 36174028; PubMed Central PMCID: PMC9522303.
  • Awasthi S, Aravamudhan S, Jagdish A, Joshi B, Mukherjee P, Kalkivaya R, et al. Transitioning ABA services from in clinic to telehealth: case study of an Indian organization’s response to COVID-19 lockdown. Behav Anal Pract. 2021;14:893–912. Epub 2021 Aug 11. PubMed PMID: 34394851; PubMed Central PMCID: PMC8356690.
  • Pramesh CS, Badwe RA. Cancer management in India during covid-19. N Engl J Med. 2020;382:e61. Epub 2020 Apr 28. PubMed PMID: 32343498; PubMed Central PMCID: PMC7207224.
  • Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131:86–92. PubMed PMID: 32243287; PubMed Central PMCID: PMC7173081.
  • McGrowder DA, Miller FG, Vaz K, Anderson Cross M, Anderson-Jackson L, Bryan S, et al. The utilization and benefits of telehealth services by health care professionals managing breast cancer patients during the COVID-19 pandemic. Healthcare. 2021;9:1401.
  • Ullas S, Pradeep M, Surendran S, Ravikumar A, Bastine AM, Prasad A, et al. Telemedicine during the COVID-19 pandemic: a paradigm shift in non-communicable disease management? - a cross-sectional survey from a quaternary-care center in South India. Patient Prefer Adherence. 2021;15:2715–2723. Epub 20211208. PubMed PMID: 34916781; PubMed Central PMCID: PMC8667749.
  • Makhlouf Y, Nessib DB, Ferjani H, Triki W, Maatallah K, Dhia K, et al. The concept of telemedicine in pediatric rheumatology in Tunisia: parents’ perceptions. J Pediatr Nurs. 2022;69:6–9. Epub 20221228. PubMed PMID: 36584592; PubMed Central PMCID: PMC9797351.
  • Mohammed Sheata I, Smith SR, Kamel H, Varrassi G, Imani F, Dayani A, et al. Pulmonary embolism and cardiac tamponade in critical care patients with COVID-19; Telemedicine’s role in developing countries: case reports and literature review. Anesth Pain Med. 2021;11:e113752. Epub 2021 Aug 03. PubMed PMID: 34336628; PubMed Central PMCID: PMC8314078.
  • Moulaei K, Sheikhtaheri A, Ghafaripour Z, Bahaadinbeigy K. The development and usability assessment of an mhealth application to encourage self-care in pregnant women against COVID-19. J Healthc Eng. 2021;2021:9968451. Epub 2021 August 03. PubMed PMID: 34336175; PubMed Central PMCID: PMC8292075.
  • Singh G, Kapoor S, Bansal V, Grewal M, Singh B, Goyal A, et al. Active surveillance with telemedicine in patients on anticoagulants during the national lockdown (COVID-19 phase) and comparison with pre-COVID-19 phase. Egypt Heart J. 2020;72:70. Epub 2020 Oct 17. PubMed PMID: 33064222; PubMed Central PMCID: PMC7562770.
  • Kumar P, Aggarwal M, Dhawan R, Dass J, Kumar G, Sharma V, et al. Future of haemophilia research in India. Indian J Hematol Blood Transfus. 2020;36: 1–6. Epub 2020 Dec 01. PubMed PMID: 33250594; PubMed Central PMCID: PMC7678769.
  • Broglio K, Kirkland KB. Rural palliative care patients’ attitudes toward telemedicine visits during the COVID-19 pandemic: a descriptive study. J Palliat Med. 2021;24:1126–1127. Epub 2021 April 23. PubMed PMID: 33885349.
  • Aneja J, Goyal T, Verma M, Kaur G, Mirza M, Gupta S. Client satisfaction with telemedicine services during COVID-19 pandemic: a cross-sectional survey from a teaching institute of North India. J Family Med Prim Care. 2022;11:5187–5193. Epub 2022 Oct 14. PubMed PMID: 36505639; PubMed Central PMCID: PMC9730979.
  • Mahmoud MA, Daboos M, Gouda S, Othman A, Abdelmaboud M, Hussein ME, et al. Telemedicine (virtual clinic) effectively delivers the required healthcare service for pediatric ambulatory surgical patients during the current era of COVID-19 pandemic: a mixed descriptive study. J Pediatr Surg. 2022;57:630–636. Epub 2021 Nov 27. PubMed PMID: 34953564; PubMed Central PMCID: PMC8626150.
  • Lima DP, Gomes VC, Viana Júnior AB, Assis FMC, Oliveira PHA, Cunha LCV, et al. Telehealth for Parkinson disease patients during the COVID-19 pandemic: the TeleParkinson study. Arq Neuropsiquiatr. 2022;80:1026–1035. Epub 2022 Dec 19. PubMed PMID: 36535287.
  • Dimer NA, Canto-Soares ND, Santos-Teixeira LD, Goulart BNG. The COVID-19 pandemic and the implementation of telehealth in speech-language and hearing therapy for patients at home: an experience report. Codas. 2020;32:e20200144. Epub 2020 Jun 25. PubMed PMID: 32578694.
  • Alam MMD, Alam MZ, Rahman SA, Taghizadeh SK. Factors influencing mHealth adoption and its impact on mental well-being during COVID-19 pandemic: a SEM-ANN approach. J Biomed Inform. 2021;116:103722. Epub 2021 March 12. PubMed PMID: 33705856.
  • Mouchtouris N, Lavergne P, Montenegro TS, Gonzalez G, Baldassari M, Sharan A, et al. Telemedicine in neurosurgery: lessons learned and transformation of care during the COVID-19 pandemic. World Neurosurg. 2020;140:e387–94. Epub 2020 Jun 09. PubMed PMID: 32512241; PubMed Central PMCID: PMC7274123.
  • Montelongo A, Becker JL, Roman R, de Oliveira EB, Umpierre RN, Gonçalves MR, et al. The management of COVID-19 cases through telemedicine in Brazil. PLoS ONE. 2021;16:e0254339. Epub 2021 Jul 15. PubMed PMID: 34260644; PubMed Central PMCID: PMC8279372.
  • Li P, Liu X, Mason E, Hu G, Zhou Y, Li W, et al. How telemedicine integrated into China’s anti-COVID-19 strategies: case from a national referral center. BMJ Health Care Inform. 2020;27:e100164. Epub 2020 Aug 25. PubMed PMID: 32830110; PubMed Central PMCID: PMC7445101.
  • Kamel H, Hafez MS, Bastawy I. Telemedicine improves the short-term medical care of acute st-segment elevation myocardial infarction after primary percutaneous coronary intervention. Front Cardiovasc Med. 2021;8:693731. Epub 2021 Jul 30. PubMed PMID: 34322529; PubMed Central PMCID: PMC8311002.
  • Chávarri-Guerra Y, Ramos-López WA, Covarrubias-Gómez A, Sánchez-Román S, Quiroz-Friedman P, Alcocer-Castillejos N, et al. Providing supportive and palliative care using telemedicine for patients with advanced cancer during the COVID-19 pandemic in Mexico. Oncology. 2021;26:e512–5. Epub 2020 Oct 24. PubMed PMID: 33094533; PubMed Central PMCID: PMC7930406 article.
  • Shaarani I, Ghanem A, Jounblat M, Jounblat H, Mansour R, Taleb R. Utilization of telemedicine by the lebanese physicians during time of pandemic. Telemed J E Health. 2021;28:219–226. Epub 2021 May 18. PubMed PMID: 33999731.
  • Franco DW, Alessi J, de Carvalho TR, Kobe GL, Oliveira GB, Knijnik CP, et al. The impact of a telehealth intervention on the metabolic profile of diabetes mellitus patients during the COVID-19 pandemic - a randomized clinical trial. Prim Care Diabetes. 2022;16:745–752. Epub 2022 Oct 30. PubMed PMID: 36266163; PubMed Central PMCID: PMC9553195.
  • Armeno M, Caballero E, Verini A, Reyes G, Galarza N, Cresta A, et al. Telemedicine- versus outpatient-based initiation and management of ketogenic diet therapy in children with drug-resistant epilepsy during the COVID-19 pandemic. Seizure. 2022;98: 37–43. Epub 2022 Apr 04. PubMed PMID: 35417828.
  • Tabuti NIM, Pellizzari C, Carrascossi H, Calice-Silva V, Figueiredo A, Gordon GM, et al. Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study. J Bras Nefrol. 2022;44: 473–481. Epub 2022 Feb 23. PubMed PMID: 35199824.
  • Shaarani I, Ghanem A, Jounblat M, Jounblat H, Mansour R, Taleb R. Utilization of telemedicine by the lebanese physicians during time of pandemic. Telemed J E Health. 2022;28:219–226. Epub 2021 May 17. PubMed PMID: 33999731.
  • Uddin Quadery SE, Hasan M, Khan MM. Consumer side economic perception of telemedicine during COVID-19 era: a survey on Bangladesh’s perspective. Inform Med Unlocked. 2021;27:100797. Epub 2021 Nov 18. PubMed PMID: 34869827; PubMed Central PMCID: PMC8627376.
  • Oliveira CRA, Etges A, Marcolino MS, Paixão MC, Mendes MS, Ribeiro LB, et al. COVID-19 telehealth service can increase access to the health care system and become a cost-saving strategy. Telemed J E Health. 2022. DOI:10.1089/tmj.2022.0240. Epub 2022 Nov 23. PubMed PMID: 36445772.
  • Zhang Z, Zhang L, Zheng J, Xiao H, Li Z. COVID-19-related disruptions and increased mhealth emergency use intention: experience sampling method study. JMIR mHealth uHealth. 2020;8:e20642. Epub 2020 Dec 15. PubMed PMID: 33315579; PubMed Central PMCID: PMC7775377.
  • Sun S, Lin D, Goldberg S, Shen Z, Chen P, Qiao S, et al. A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: a randomized controlled trial. J Couns Psychol. 2021. DOI:10.1037/cou0000568. Epub 2021 Jul 16. PubMed PMID: 34264696.
  • Lai FH, Yan EW, Yu KK, Tsui WS, Chan DT, Yee BK. The protective impact of telemedicine on persons with dementia and their caregivers during the COVID-19 pandemic. Am J Geriatr Psychiatry. 2020;28:1175–1184. Epub 2020 Sept 03. PubMed PMID: 32873496; PubMed Central PMCID: PMC7413846.
  • Irarrázaval MJ, Inzunza M, Muñoz R, Quezada N, Brañes A, Gabrielli M, et al. Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic. Surg Endosc. 2021;35:6300–6306. Epub 2020 Nov 04. PubMed PMID: 33140151; PubMed Central PMCID: PMC7605475.
  • Guo Z, Ma N, Wu Y, Yuan H, Luo W, Zeng L, et al. The safety and feasibility of the screening for retinopathy of prematurity assisted by telemedicine network during COVID-19 pandemic in Wuhan, China. BMC Ophthalmol. 2021;21:258. Epub 2021 Jun 12. PubMed PMID: 34112134; PubMed Central PMCID: PMC8192130.
  • Efe C, Simşek C, Batıbay E, Calışkan AR, Wahlin S. Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic. Expert Rev Gastroenterol Hepatol. 2020;14:1215–1219. Epub 2020 Sept 11. PubMed PMID: 32909852.
  • Alessi J, de Oliveira GB, Franco DW, Becker AS, Knijnik CP, Kobe GL, et al. Telehealth strategy to mitigate the negative psychological impact of the COVID-19 pandemic on type 2 diabetes: a randomized controlled trial. Acta Diabetol. 2021;58:899–909. Epub 2021 Mar 17. PubMed PMID: 33723649; PubMed Central PMCID: PMC7959296.
  • Schlichting T, Martins da Silva K, Silva Moreira R, Marques de Moraes MV, Cicuto Ferreira Rocha NA, Boyd RN, et al. Telehealth program for infants at risk of cerebral palsy during the covid-19 pandemic: a pre-post feasibility experimental study. Phys Occup Ther Pediatr. 2022;42:490–509. Epub 2022 Mar 27. PubMed PMID: 35341469.
  • Okan F, Okan S, Duran Yücesoy F. Evaluating the efficiency of breathing exercises via telemedicine in post-covid-19 patients: randomized controlled study. Clin Nurs Res. 2022;31:771–781. Epub 2022 Apr 29. PubMed PMID: 35485738.
  • Zubarioglu T, Hopurcuoglu D, Uygur E, Ahmadzada S, Oge-Enver E, Isat E, et al. The impact of telemedicine for monitoring and treatment of phenylketonuria patients on metabolic outcome during coronavirus disease-19 outbreak. Telemed J E Health. 2022;28:258–265. Epub 2021 Mar 12. PubMed PMID: 33719565.
  • Areevut C, Sakmanarit J, Tachanivate P, Jerawatana R, Vittayakasemsont K, Pookate W, et al. Noninferiority of telemedicine delivered compared with in-person diabetes self-management education and support (DSMES) during covid-19 pandemic in Thailand. Asia Pac J Public Health. 2022;34:799–803. Epub 2022 Sept 19. PubMed PMID: 36124368; PubMed Central PMCID: PMC9679207.
  • Beşer ÖF, Karaboğa EPU, Hepkaya E, Kılınç Sakallı AA, Dönmez Türkmen A, Dilek TD, et al. The role of telehealth services in children with cystic fibrosis during coronavirus disease 2019 outbreak. Telemed J E Health. 2022;28:832–837. Epub 2021 Oct 07. PubMed PMID: 34619057.
  • Calikoglu F, Bagdemir E, Celik S, Idiz C, Ozsarı H, Issever H, et al. Telemedicine as a motivational tool to optimize metabolic control in patients with diabetes in turkey: a prospective, randomized, controlled telediab trial. Telemed J E Health. 2022. DOI:10.1089/tmj.2022.0028. Epub 2022 Sept 02. PubMed PMID: 36067018.
  • Singh NN, Lancioni GE, Medvedev ON, Hwang YS, Myers RE. Real-time telehealth treatment team consultation for self-injury by individuals with autism spectrum disorder. Adv Neurodev Disord. 2021:1–13. DOI:10.1007/s41252-021-00192-z. Epub 2021 Jan 26. PubMed PMID: 33490369; PubMed Central PMCID: PMC7813971.
  • Severini R, Oliveira PC, Couto TB, Simon Junior H, Andrade APM, Nanbu DY, et al. Fast, cheap and feasible: implementation of pediatric telemedicine in a public hospital during the covid-19 pandemic. J Pediatr (Rio J). 2021;98: 183–189. Epub 2021 Jun 29. PubMed PMID: 34181889; PubMed Central PMCID: PMC8196314.
  • Nascimento BR, Brant LC, Castro ACT, Froes LEV, Ribeiro ALP, Cruz LV, et al. Impact of a large-scale telemedicine network on emergency visits and hospital admissions during the coronavirus disease 2019 pandemic in Brazil: data from the UNIMED-BH system. J Telemed Telecare. 2020;29: 1357633x20969529. Epub 2020 Oct 27. PubMed PMID: 33100183.
  • Arora M, Harvey LA, Glinsky JV, Chhabra HS, Hossain MS, Arumugam N, et al. Cost-effectiveness analysis of telephone-based support for the management of pressure ulcers in people with spinal cord injury in India and Bangladesh. Spinal Cord. 2017;55:1071–1078. Epub 2017 Aug 15. PubMed PMID: 28809389.