Home telemonitoring and quality of life in stable, optimised chronic obstructive pulmonary disease

Abstract

We conducted a six-month randomised controlled trial of home telemonitoring for patients with chronic obstructive pulmonary disease (COPD). A total of 40 stable patients with moderate to severe COPD who had completed pulmonary rehabilitation took part. They were randomised to receive standard care (controls) or standard care plus home telemonitoring (intervention). During the monitoring period, patients in the telemonitoring group recorded their symptoms and physical observations twice daily. The data were transmitted automatically at night via the home telephone line. Nurses could access the data through a website and receive alerting email messages if certain conditions were detected. The patients completed the St George's Respiratory Questionnaire, Hospital Anxiety and Depression and the EuroQoL EQ-5D quality of life scores before and after pulmonary rehabilitation, and then periodically during the trial. There were significant and clinically important improvements in the scores immediately following pulmonary rehabilitation, but thereafter there were no differences in quality of life scores between the groups at any time, or consistently within either group over time. The study showed that telemonitoring was safe but, despite being well used, it was not associated with changes in quality of life in patients who had stable COPD.

Systematic review and meta‐analysis of studies involving telehome monitoring‐based telenursing for patients with chronic obstructive pulmonary disease

“…Other studies were excluded because of lack of telemonitoring or comparators. Four RCT (Kamei et al, 2011a(Kamei et al, , 2011bLewis et al, 2010aLewis et al, , 2010b) that were based on the same samples but reported different outcomes were also included ( Fig. 1).…”

“…Countries of origin of the nine articles included the UK (n = 2; Lewis et al, 2010aLewis et al, , 2010b, Japan (n = 2; Kamei et al, 2011aKamei et al, , 2011b, Denmark (n = 1; Sorknaes et al, 2011), Italy (n = 1; Vittaca et al, 2009), Australia (n = 1; Shany et al, 2010), the Netherlands (n = 1; Trappenburg et al, 2008), and Spain (n = 1; de Toledo et al, 2006). THMTN duration ranged from 1 month (Sorknaes et al, 2011) to 12 months (de Toledo et al, 2006;Shany et al, 2010;Vittaca et al, 2009) (Table 1).…”

Systematic Review of Telemonitoring in COPD: An Update

“…In particular, it can be noticed that the benefit of telemedicine interventions were at best small in studies including education on self-care [13,16] or the patients were already followed in the center in which the experiment took place [14]. Interestingly, when education on self-care was offered only to telemedicine group, the reduction of hospitalizations in the intervention group was more evident [10,11].…”

“…Five studies used the St. George's Respiratory Questionnaire (SGRQ). A statistically and clinically (>= 4 points) significant improvement in SGRQ score was reported only by Koff et al Two trials documented a non-statistically significant change >= 4 points in SGRQ in telemonitoring group compared with control group [18,21] and four studies did not show differences in quality of life between groups [11,13,14,16].…”

“…In some cases [10,11], information was obtained by a nurse using questionnaires in telephone interviews, in others [12,13] a mobile phone were used to transmit data collected using commercially available devices. In some instances, a portable unit including measuring devices acted as measuring and transmitting device [14][15][16]. Data were transmitted using the Internet in eight trials, the broadband mobile phone connection in two trials; while two trials used telephone interviews.…”