Pilot Study of Remote Telemonitoring in COPD

Antoniades, Nick C.; Rochford, Peter D.; Pretto, Jeffrey J.; Pierce, Robert J; Gogler, Janette; Steinkrug, Julie; Sharpe, Ken; McDonald, Christine F

doi:10.1089/tmj.2011.0231

Cited by 81 publications

(114 citation statements)

References 19 publications

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“…Most of them (4/6) reported a reduction in number of COPD-related hospitalizations, with a risk reduction ranging from 14% [18] to 69% [17]; no study, however, reached statistical significance. Only Chau et al [13] reported a non-statistically significant increase in number of COPD-related hospitalization; Pinnock et al did not document a difference between the two groups [16].…”

Section: Effect On Copd-related Hospital Admissionsmentioning

confidence: 90%

“…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].…”

Section: Effect On Quality Of Lifementioning

confidence: 94%

“…Two studies [13,17] only reported data on COPD-related admission. Most studies (6/10) reported a positive effect of telemonitoring on hospitalization for any cause, with risk reductions between 10% [18] and 40% [15], with the noticeable exception of Segrelles et al that reported a risk reduction of 63% [19]. In only three of these positive studies [10,19,20], however, the results reached statistical significance.…”

Section: Effect On Hospital Admissionsmentioning

confidence: 97%

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Systematic Review of Telemonitoring in COPD: An Update

Pedone

Lelli

2015

Advances in Respiratory Medicine

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Telemedicine may support individual care plans in people with chronic obstructive pulmonary disease (COPD), potentially improving the clinical outcomes. To-date there is no clear evidence of benefit of telemedicine in this patients. The aim of this study is to provide an update on the effectiveness of telemedicine in reducing adverse clinical outcomes. We searched the Pubmed database for articles published between January 2005 and December 2014. We included only randomized controlled trials exclusively focused on patients with COPD and with a telemedicine intervention arm. Evaluated outcomes were number of exacerbations, ER visits, COPD hospitalizations, length of stay and death. We eventually included 12 randomized controlled trials. Most of them had a small sample size and was of poor quality, with a wide heterogeneity in the parameters and technologies used. Most studies reported a positive effect of telemonitoring on hospitalization for any cause, with risk reductions between 10% and 63%; however only three studies reached statistical significance. The same trend was observed for COPD-related hospital admission and ER visits. No significative effects of telemedicine was evidenced in reducing length of hospital stay, improving quality of life and reducing deaths.In conclusion, our study confirms that the available evidence on the effectiveness of telemedicine in COPD does not allow to draw definite conclusions; most evidence suggests a positive effect of telemonitoring on hospital admissions and ER visits. More trials with adequate sample size and with adequate consideration of background clinical services are needed to definitively establish its effectiveness.

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Section: Effect On Copd-related Hospital Admissionsmentioning

confidence: 90%

Section: Effect On Quality Of Lifementioning

confidence: 94%

Section: Effect On Hospital Admissionsmentioning

confidence: 97%

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Systematic Review of Telemonitoring in COPD: An Update

Pedone

Lelli

2015

Advances in Respiratory Medicine

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“…Данная рекомендация основана на РКИ [118][119][120], проанализированных в систематическом обзо ре [121], и дополнительных РКИ [122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139]. Из них только 6 исследований были объединены для данной рекомендации [127,[130][131][132][133][134], хотя эксперты также принимали во внимание и результаты других иссле дований, не включенных в метаанализ.…”

Section: клинические рекомендацииunclassified

Therapeutic strategy to prevent acute exacerbations of chronic obstructive pulmonary disease: clinical guidelines of American College of Chest Physicians and Canadian Thoracic Society Guideline (Part 1)

Редакционная¹

2016

Pulʹmonologiâ (Mosk.)

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РезюмеХроническая обструктивная болезнь легких (ХОБЛ) является одной из основных причин заболеваемости и летальности в США и в ми ре. Обострения ХОБЛ (периодическое усиление кашля, одышки и продукции мокроты) вносят серьезный вклад в снижение легочной функции, качества жизни, повышение потребности в неотложной помощи и госпитализациях, а также в стоимость лечения больных. В последние десятилетия выполнены исследования, по результатам которых существенно углубилось понимание патогенеза ХОБЛ и расширились терапевтические возможности. Накоплен также большой объем публикаций по предотвращению обострений ХОБЛ. Материалы и методы. Для разъяснения важности предотвращения обострений ХОБЛ Американской коллегией торакальных врачей (American College of Chest Physicians -CHEST) и Канадским торакальным обществом (Canadian Thoracic Society Guideline -CTS) раз работаны совместные Клинические рекомендации, в которых описан существующий сегодня подход к профилактике обострений ХОБЛ. Выделены 3 основных клинических проблемы профилактики обострений ХОБЛ на основе принципов PICO (Population, Intervention, Comparator, Outcome -Популяция, Вмешательства, Сравнение, Исходы) -немедикаментозное лечение, ингаляционная и пероральная терапия. Использована общепринятая система отбора соответствующих клинических исследований и оценки класса ре комендаций. Результаты. Особенность Клинических рекомендаций по профилактике обострений ХОБЛ заключается не только в их те матике, но также в том, что они стали первым результатом сотрудничества 2 крупных торакальных обществ Северной Америки. Наме рение Надзорного комитета по созданию клинических рекомендаций CHEST в сотрудничестве с Клинической ассамблеей по ХОБЛ CTS заключается в том, чтобы на основе систематического обзора и критической оценки опубликованной литературы, сделанных кли ническими экспертами и исследователями в области ХОБЛ, разработать клинические рекомендации с целью помочь клиницистам в ве дении пациентов с этим заболеванием. Заключение. В данных Рекомендациях содержится современный доказательный анализ опубли кованных результатов рандомизированных контролируемых исследований по профилактике обострений ХОБЛ. SummaryChronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. An acute exacerbation of COPD great ly contributes to worsening lung function, impairment in quality of life, need for urgent care, and use of medical utilities. Last decade, our under standing of the pathogenesis and treatment of COPD has significantly improved. The guideline accumulated recent information about the prevention of acute exacerbations of COPD. Methods. The American College of Chest Physicians and Canadian Thoracic Society developed evidence based guideline to describe the current knowledge on the prevention of acute exacerbations in a clinically useful manner. The PICO approach (population, intervention, comparator, and outcome) was used which involved nonpharmacologic therapies, inhaled therapies, and oral therapies. To select the most appropriate studi...

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“…A randomised, controlled trial of 1,653 patients across 33 cardiology practices in the USA, suggested that there was no significant difference in hospital readmissions, length of stay, and mortality rate within 180 days after study enrolment . Another study examining hospital admission rates and hospital length of stay in patients with chronic obstructive pulmonary disease (COPD) indicated that remote monitoring did not support favourable results in hospital utilisation (Antoniades et al, 2012).…”

Section: Quality and Millmentioning

confidence: 99%

An ethical analysis of telemedicine: implications for future research

White-Williams

Oetjen

2015

IJTMCP

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Abstract:The challenges in healthcare have led to a system wide exploration of the potential benefits of remote monitoring. To comprehensively evaluate its utility, researchers, decision makers, and healthcare practitioners should assess remote monitoring in light of its ethical ramifications. This manuscript will consider two philosophical perspectives, teleology and deontology. Teleology, as supported by John Stuart Mill's utilitarian position, holds that the morality of a decision is based upon its consequences. In response, philosopher John Rawls offers a deontological framework, which supports remote monitoring if it benefits the most disadvantaged in society. It is through these philosophical frameworks that remote monitoring will be analysed in relation to its ability to affect change in access, quality, and cost of healthcare. Implications for future public health research will also be discussed.

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Pilot Study of Remote Telemonitoring in COPD

Abstract: The addition of RM to SBP was feasible but did not reduce healthcare utilization or improve quality of life in this group of patients already receiving comprehensive respiratory care.

Cited by 81 publications

References 19 publications

Systematic Review of Telemonitoring in COPD: An Update

Systematic Review of Telemonitoring in COPD: An Update

Therapeutic strategy to prevent acute exacerbations of chronic obstructive pulmonary disease: clinical guidelines of American College of Chest Physicians and Canadian Thoracic Society Guideline (Part 1)

An ethical analysis of telemedicine: implications for future research

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