Effectiveness of remote home monitoring for patients with Chronic Obstructive Pulmonary Disease (COPD): systematic review

Abstract

Background Although remote home monitoring (RHM) has the capacity to prevent exacerbations in patients with chronic obstructive pulmonary disease (COPD), evidence regarding its effectiveness remains unclear. The objective of this study was to determine the effectiveness of RHM in patients with COPD. Methods A systematic review of the scholarly literature published within the last 10 years was conducted using internationally recognized guidelines. Search strategies were applied to several electronic databases and clinical trial registries through March 2020 to identify studies comparing RHM to ‘no remote home monitoring’ (no RHM) or comparing RHM with provider’s feedback to RHM without feedback. To critically appraise the included randomized studies, the Cochrane Collaboration risk of bias tool (ROB) was used. The quality of included non-randomized interventional and comparative observational studies was evaluated using the ACROBAT-NRSI tool from the Cochrane Collaboration. The quality of evidence relating to key outcomes was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE) on the following: health-related quality of life (HRQoL), patient experience and number of exacerbations, number of emergency room (ER) visits, COPD-related hospital admissions, and adherence as the proportion of patients who completed the study. Three independent reviewers assessed methodologic quality and reviewed the studies. Results Seventeen randomized controlled trials (RCTs) and two comparative observational studies were included in the review. The primary finding of this systematic review is that a considerable amount of evidence relating to the efficacy/effectiveness of RHM exists, but its quality is low. Although RHM is safe, it does not appear to improve HRQoL (regardless of the type of RHM), lung function or self-efficacy, or to reduce depression, anxiety, or healthcare resource utilization. The inclusion of regular feedback from providers may reduce COPD-related hospital admissions. Though adherence RHM remains unclear, both patient and provider satisfaction were high with the intervention. Conclusions Although a considerable amount of evidence to the effectiveness of RHM exists, due to heterogeneity of care settings and the low-quality evidence, they should be interpreted with caution.

The use of telemedicine in lung diseases with focus on chronic obstructive pulmonary disease

“…På internationalt plan er evidensen begraenset af ekstern validitet og små studiepopulationer [10][11][12][13][14][15][16][17]. Kun i ét review fandt man, at telemedicinske tiltag medførte en reduktion i antallet af indlaeggelser [13], mens man i én metaanalyse fandt en signifikant nedgang i antallet af henvendelser til skadestuen pga.…”

“…I artiklerne konkluderes det derudover, at telemedicin er nemt at integrere og implementere i den konventionelle KOL-behandling [11,12]. I seks af de otte eksisterende systematiske review konkluderes det, at studierne er heterogene, hvad angår valg af metode og fokus, hvilket begraenser muligheden for sammenligning på tvaers af studierne [10,[12][13][14][15]17]. I seks af otte systematiske review fandt man, at studierne var af dårlig eller mangelfuld kvalitet [10,12,[14][15][16][17].…”

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“…These technologies have the potential to help control rising healthcare costs, improve efficiency of care, and address staffing challenges that may be present in PR. Two recent systematic reviews examined the effectiveness of remote home monitoring devices (smartphones, apps and tablets) on outcomes that included exercise capacity and physical activity [ 108 , 109 ]. The lengths of the monitoring periods in these two reviews ranged from 1 to 12 months.…”

“…The lengths of the monitoring periods in these two reviews ranged from 1 to 12 months. While the body of evidence to date is generally small and of low quality [ 108 , 109 ], there is some evidence suggesting the use of these devices may facilitate improvements in these two outcome areas. For example, use of a smartphone-type self-management app resulted in an increase in the 6-min walk distance from baseline, but the degree of improvement was similar to that observed in the control group not using the smartphone [ 110 ].…”

Triboelectric and Piezoelectric Nanogenerators for Self-Powered Healthcare Monitoring Devices: Operating Principles, Challenges, and Perspectives

“…The world population could reach 8.5 billion and 9.7 billion in 2030 and 2050, respectively [8]. In addition, digital home hospitalization is suitable for people with chronic diseases who live in isolated areas [9,10]. Thus, patients could be cared for from their homes, preserving their integrity with the help of the implementation of a wireless patient monitoring tool.…”