Abstract WP297: Impact of Telemedicine for Stroke Care in Latin America and the Caribbean: A Systematic Review

Introduction: Stroke represents a leading cause of death and disability in Latin America and the Caribbean (LAC). Telemedicine has emerged as a promising tool to improve access to specialized stroke care, especially in remote and underserved regions. This systematic review summarizes the evidence on the implementation of telemedicine for stroke care in LAC. Methods: A systematic search was conducted on July 25, 2025, in PubMed, Scielo, Scopus, Embase, and Web of Science, without language restrictions. This was supplemented by gray literature identified from reference lists and the first 10 pages of Google Scholar. The review followed PRISMA 2020 guidelines, and study quality was assessed using the Newcastle-Ottawa Scale (NOS). Two trained reviewers independently screened studies after pilot training. Data synthesis was descriptive. Results: Thirty studies from seven countries in LAC were included (Brazil 40%, Chile 20%, Colombia 20%, and others 20%). The study designs were retrospective (43.3%), prospective (16.7%), cross-sectional (13.3%), and other (26.7%). The most common telemedicine applications were telestroke (86.7%) and tele-rehabilitation (10.0%), delivered primarily via smartphones (46.7%), videoconference (33.3%), and tablets (13.3%). Ischemic stroke was the most frequently addressed condition (73.3%). Key benefits included reduced door-to-needle time (reductions of 27–55 minutes), increased thrombolysis rates (up to 31.8%), and improved access to specialists in remote areas. Limitations included technological dependency, small sample sizes, and a lack of long-term functional outcomes. Risk of bias was low in 40% of studies, moderate in 43.3%, and high in 16.7%. Conclusions: Telemedicine could be a viable and effective strategy for improving acute stroke care and rehabilitation in LAC, reducing delays in treatment and expanding access to specialized care. However, challenges remain related to infrastructure, training, and equitable implementation. Future efforts should focus on standardizing protocols, expanding connectivity, and evaluating long-term functional outcomes to ensure sustainable integration into health systems.