Barriers and facilitators of integrating telemedicine services into routine kidney transplant patient care: a scoping review of qualitative research

Introduction: Considering recent advances in technology, kidney transplant patients can significantly benefit from telemedicine. Understanding the factors that influence its integration into routine care is essential for optimizing implementation and ensuring equitable access. Methods: This review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The electronic databases including PubMed, Web of Science, Embase, Scopus and ProQuest were searched. Relevant studies were evaluated and selected by two authors independently. The extracted data were analyzed and synthesized using a thematic approach. Barriers and facilitators of integrating telemedicine services into routine kidney transplant patients care were extracted based on four pre-defined main themes (Human, Organizational, Technological, and economic environments). Results: From 1,188 records screened, 17 qualitative studies were selected for inclusion. Analysis revealed multiple barriers and facilitators to telemedicine integration in kidney transplant care, categorized into four main areas: human factors, organizational issues, technological challenges, and economic considerations. Key barriers identified included limited technological infrastructure, patient and provider resistance to digital tools, technology literacy gaps, privacy concerns, and increased workload. Facilitators highlighted were comprehensive guidelines, training programs, user-friendly platforms, ongoing technical support, and strong physician-patient relationships. These synthesized insights highlighted a set of 27 facilitators that can support telemedicine implementation. Conclusion: The integration of telemedicine services into routine kidney transplant patient care faces many challenges but also offers promising facilitators. Addressing these factors is crucial to improving telemedicine implementation and enhancing patient outcomes.