Personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial

Mudiyanselage, Shalika Bohingamu; Stevens, Jo; Watts, Jennifer J.; Toscano, Julian; Kotowicz, Mark A.; Steinfort, Christopher L.; Bell, Jennifer; Byrnes, Janette; Bruce, Stephanie; Carter, Sarah; Hunter, Claire; Barrand, Chris; Hayles, Robyn

doi:10.1177/1357633x18775850

Cited by 47 publications

(68 citation statements)

References 22 publications

(26 reference statements)

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“…In this regard, a randomized controlled trial aiming to assess the effect of home telemonitoring systems on health, quality of life, and annual expenses of patients with diabetic and COPD, had revealed that during the utilization of this system, hospitalization expenses decreased, which compensated for the expense of implementing telemedicine. This study showed that telemonitoring had led to a higher quality of life for patients in the intervention groups while preserving the quality of services (9).…”

Section: The Aging Population and Chronic Diseasesmentioning

confidence: 68%

The necessity of implementing telemedicine systems in the Islamic Republic of Iran

Keshvardoost¹,

Dehnavieh²,

Bahaadinibeigy³

2021

East Mediterr Health J.

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Section: The Aging Population and Chronic Diseasesmentioning

confidence: 68%

The necessity of implementing telemedicine systems in the Islamic Republic of Iran

Keshvardoost¹,

Dehnavieh²,

Bahaadinibeigy³

2021

East Mediterr Health J.

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“…The lack of effect in this study is not unique, as current studies and reviews on the effects of remote monitoring on patient outcomes and health utilization have shown mixed results [ 16 - 18 ]. Some studies have reported positive results on some quality of life measures and symptoms [ 10 , 33 - 35 ], but many have reported no effects [ 8 , 12 , 36 - 39 ]. With respect to health care utilization, the effects are also mixed, with some reporting reductions in hospitalizations [ 5 , 7 , 33 , 40 - 42 ], length of stay [ 7 , 33 , 40 , 43 ], and ED visits [ 33 , 40 ], but many failing to find significant effects [ 6 , 10 , 34 , 36 - 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Remote monitoring programs are always monitored by a health care provider, even though they are sometimes referred to as self-management programs, as the recordings are taken by the patients [ 10 ]. Some remote monitoring programs also often have an educational component [ 11 , 12 ] such as coaching sessions to support self-management. COPD self-management behaviors include self-recognition and self-treatment of exacerbations (eg, taking medications); coping with breathlessness; and lifestyle changes such as quitting smoking, eating healthy, and exercising [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Technology-Enabled Self-Management of Chronic Obstructive Pulmonary Disease With or Without Asynchronous Remote Monitoring: Randomized Controlled Trial

Stamenova¹,

Liang²,

Yang³

et al. 2020

J Med Internet Res

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Background Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and leads to frequent hospital admissions and emergency department (ED) visits. COPD exacerbations are an important patient outcome, and reducing their frequency would result in significant cost savings. Remote monitoring and self-monitoring could both help patients manage their symptoms and reduce the frequency of exacerbations, but they have different resource implications and have not been directly compared. Objective This study aims to compare the effectiveness of implementing a technology-enabled self-monitoring program versus a technology-enabled remote monitoring program in patients with COPD compared with a standard care group. Methods We conducted a 3-arm randomized controlled trial evaluating the effectiveness of a remote monitoring and a self-monitoring program relative to standard care. Patients with COPD were recruited from outpatient clinics and a pulmonary rehabilitation program. Patients in both interventions used a Bluetooth-enabled device kit to monitor oxygen saturation, blood pressure, temperature, weight, and symptoms, but only patients in the remote monitoring group were monitored by a respiratory therapist. All patients were assessed at baseline and at 3 and 6 months after program initiation. Outcomes included self-management skills, as measured by the Partners in Health (PIH) Scale; patient symptoms measured with the St George’s Respiratory Questionnaire (SGRQ); and the Bristol COPD Knowledge Questionnaire (BCKQ). Patients were also asked to self-report on health system use, and data on health use were collected from the hospital. Results A total of 122 patients participated in the study: 40 in the standard care, 41 in the self-monitoring, and 41 in the remote monitoring groups. Although all 3 groups improved in PIH scores, BCKQ scores, and SGRQ impact scores, there were no significant differences among any of the groups. No effects were observed on the SGRQ activity or symptom scores or on hospitalizations, ED visits, or clinic visits. Conclusions Despite regular use of the technology, patients with COPD assigned to remote monitoring or self-monitoring did not have any improvement in patient outcomes such as self-management skills, knowledge, or symptoms, or in health care use compared with each other or with a standard care group. This may be owing to low health care use at baseline, the lack of structured educational components in the intervention groups, and the lack of integration of the action plan with the technology. Trial Registration ClinicalTrials.gov NCT03741855; https://clinicaltrials.gov/ct2/show/ NCT03741855

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“…Development of new technology innovations and their different telemedicine applications in integrated care programs, such as teleassessments, have positive effects on the quality of care in chronic patients. 14,15,17,18 Although telemedicine has been shown to be useful for screening, diagnosis, and management in different studies, [19][20][21] there are still serious difficulties including deficiency of provider availability, community access to screening, and community demand for screening. 22,23 Challenges related to health care providers can involve scarcity in screening delivery or policies requiring a consultation from a family physician to access screening.…”

Section: Introductionmentioning

confidence: 99%

Mobile Screening Units for the Early Detection of Breast Cancer and Cardiovascular Disease: A Pilot Telemedicine Study in Southern Italy

Marino

Rienzo

Serra

et al. 2020

Telemedicine and e-Health

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Introduction: Telemedicine is the use of Information and Communication Technologies (ICT) to improve patient outcomes by increasing access to care, medical information and services. The aim of this pilot study was to evaluate and support the implementation of screening and early detection programs in the prevention of breast cancer and cardiovascular diseases with the establishment of a remote diagnosis through the use of ICT in mobile units. Materials and Methods: A total of 430 individuals were recruited in an area of Southern Italy. Particularly, 321 women were recruited to undergo breast cancer screening in accordance with Italian guidelines. Likewise, cardiovascular screening interested 109 subjects. A self-contained mobile unit with connectivity was provided to offer breast and cardiovascular screenings. To maximize the benefit, we have evaluated the return of investment. Results: The telemedicine screening program allowed the detection of early pathologies. In breast cancer screening, 40.8% of cases were negative to lesions, 34.9% were positive to benign lesions, and 3.1% presented suspicious malignant lesions; these lesions were further checked by histological analyses, which showed a positive response in 70% of cases. The cardiovascular screening concerned 109 participants based on age and other risk factors. We observed a significant difference among risk factors in patients with cardiac disease (p < 0.001); particularly, hypertension was significantly the most present risk factor (51.4%, p < 0.05), followed by smoking (28.4%, p < 0.05). A cardiovascular pathology was detected in 40.4% of enrolled subjects. A 3.3:1 return on investment was calculated. Conclusion: Our findings demonstrate that telemedicine may represent a promising approach to deliver several health services, such as screening programs, with users who cannot utilize services in their locations. The use of telemedicine on diagnostic campers greatly reduces the costs of screening for breast cancer and major cardiovascular diseases within the Southern Italian Health Service. We believe that public investment can have a further significant return on investment by implementing the principles of precision medicine.

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Personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial

Cited by 47 publications

References 22 publications

The necessity of implementing telemedicine systems in the Islamic Republic of Iran

The necessity of implementing telemedicine systems in the Islamic Republic of Iran

Technology-Enabled Self-Management of Chronic Obstructive Pulmonary Disease With or Without Asynchronous Remote Monitoring: Randomized Controlled Trial

Mobile Screening Units for the Early Detection of Breast Cancer and Cardiovascular Disease: A Pilot Telemedicine Study in Southern Italy

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