Telehealthcare for chronic obstructive pulmonary disease

McLean, Susannah; Nurmatov, Ulugbek; Liu, Joseph L. Y.; Pagliari, Claudia; Car, Josip; Sheikh, Aziz

doi:10.1002/14651858.cd007718.pub2

Cited by 159 publications

(131 citation statements)

References 60 publications

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“…One review on chronic obstructive pulmonary disease (COPD) demonstrated the capacity of eHealth interventions to significantly reduce the number of patients with 1 or more emergency department visits or hospital admissions-due to exacerbation of pulmonary symptoms-over a 12-month period [23]. eHealth interventions did not significantly improve quality of life and all-cause mortality.…”

Section: Resultsmentioning

confidence: 99%

“…Among the systematic reviews and meta-analyses described in the current review are 4 high-quality Cochrane reviews [6,14,23,38]. Following the PRISMA Statement [10], the methodological quality of the other included papers was generally considered high.…”

Section: Resultsmentioning

confidence: 99%

“…Instead, they performed a qualitative analysis of their findings. Several papers presented the results of a pooled analysis or subanalysis, despite substantial heterogeneity (ie, I 2 value >50) [6,12-14,23,24]. Three studies did not report heterogeneity [11,16,38].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

Elbert

Os‐Medendorp²,

Renselaar³

et al. 2014

J Med Internet Res

348

233

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BackgroundeHealth potentially enhances quality of care and may reduce health care costs. However, a review of systematic reviews published in 2010 concluded that high-quality evidence on the benefits of eHealth interventions was still lacking.ObjectiveWe conducted a systematic review of systematic reviews and meta-analyses on the effectiveness/cost-effectiveness of eHealth interventions in patients with somatic diseases to analyze whether, and to what possible extent, the outcome of recent research supports or differs from previous conclusions.MethodsLiterature searches were performed in PubMed, EMBASE, The Cochrane Library, and Scopus for systematic reviews and meta-analyses on eHealth interventions published between August 2009 and December 2012. Articles were screened for relevance based on preset inclusion and exclusion criteria. Citations of residual articles were screened for additional literature. Included papers were critically appraised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement before data were extracted. Based on conclusions drawn by the authors of the included articles, reviews and meta-analyses were divided into 1 of 3 groups: suitable, promising, or limited evidence on effectiveness/cost-effectiveness. Cases of uncertainty were resolved by consensus discussion. Effect sizes were extracted from papers that included a meta-analysis. To compare our results with previous findings, a trend analysis was performed.ResultsOur literature searches yielded 31 eligible reviews, of which 20 (65%) reported on costs. Seven papers (23%) concluded that eHealth is effective/cost-effective, 13 (42%) underlined that evidence is promising, and others found limited or inconsistent proof. Methodological quality of the included reviews and meta-analyses was generally considered high. Trend analysis showed a considerable accumulation of literature on eHealth. However, a similar percentage of papers concluded that eHealth is effective/cost-effective or evidence is at least promising (65% vs 62%). Reviews focusing primarily on children or family caregivers still remained scarce. Although a pooled (subgroup) analysis of aggregate data from randomized studies was performed in a higher percentage of more recently published reviews (45% vs 27%), data on economic outcome measures were less frequently reported (65% vs 85%).ConclusionsThe number of reviews and meta-analyses on eHealth interventions in patients with somatic diseases has increased considerably in recent years. Most articles show eHealth is effective/cost-effective or at least suggest evidence is promising, which is consistent with previous findings. Although many researchers advocate larger, well-designed, controlled studies, we believe attention should be given to the development and evaluation of strategies to implement effective/cost-effective eHealth initiatives in daily practice, rather than to further strengthen current evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

Elbert

Os‐Medendorp²,

Renselaar³

et al. 2014

J Med Internet Res

348

233

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“…Telehealth care has been shown to reduce hospitalizations in patients with chronic conditions such as asthma [6], chronic obstructive pulmonary disease [7], and heart failure [8,9]. Data also shows that telehealth care can achieve better blood pressure [17,18] and glycemic control [19].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Cost-Effectiveness and Clinical Outcomes of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease

Ho¹,

Yu²,

Lin³

et al. 2014

J Med Internet Res

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BackgroundTelehealth programs are a growing field in the care of patients. The evolution of information technology has resulted in telehealth becoming a fourth-generation synchronous program. However, long-term outcomes and cost-effectiveness analysis of fourth-generation telehealth programs have not been reported in patients with chronic cardiovascular diseases.ObjectiveWe conducted this study to assess the clinical outcomes and cost-effectiveness of a fourth-generation synchronous telehealth program for patients with chronic cardiovascular diseases.MethodsWe retrospectively analyzed 575 patients who had joined a telehealth program and compared them with 1178 patients matched for sex, age, and Charlson comorbidity index. The program included: (1) instant transmission of biometric data, (2) daily telephone interview, and (3) continuous decision-making support. Data on hospitalization, emergency department (ED) visits, and medical costs were collected from the hospital’s database and were adjusted to the follow-up months.ResultsThe mean age was 64.5 years (SD 16.0). The mean number of monthly ED visits (mean 0.06 SD 0.13 vs mean 0.09 SD 0.23, P<.001), hospitalizations (mean 0.05 SD 0.12 vs mean 0.11 SD 0.21, P<.001), length of hospitalization (mean 0.77 days SD 2.78 vs mean 1.4 SD 3.6, P<.001), and intensive care unit admissions (mean 0.01 SD 0.07 vs mean 0.036 SD 0.14, P<.001) were lower in the telehealth group. The monthly mean costs of ED visits (mean US$20.90 SD 66.60 vs mean US$37.30 SD 126.20, P<.001), hospitalizations (mean US$386.30 SD 1424.30 vs mean US$878.20 SD 2697.20, P<.001), and all medical costs (mean US$587.60 SD 1497.80 vs mean US$1163.60 SD 3036.60, P<.001) were lower in the telehealth group. The intervention costs per patient were US$224.80 per month. Multivariate analyses revealed that age, telehealth care, and Charlson index were the independent factors for ED visits, hospitalizations, and length of hospitalization. A bootstrap method revealed the dominant cost-effectiveness of telehealth care over usual care.ConclusionsBetter cost-effectiveness and clinical outcomes were noted with the use of a fourth-generation synchronous telehealth program in patients with chronic cardiovascular diseases. The intervention costs of this new generation of telehealth program do not increase the total costs for patient care.

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“…However, subsequent studies have found telemedicine to be useful for monitoring chronic patients. Telecare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital [12]. In our study, telemedicine was combined with face-to-face consultation once a month, which allowed us to see the patient in person and check the telemedicine equipment.…”

Section: Discussionmentioning

confidence: 99%

– New methods Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure

Zamarrón¹,

Morete²,

González³

2014

aoms

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IntroductionNeuromuscular diseases cause a number of limitations which may be improved by using a telemedicine system. These include functional impairment and dependence associated with muscle weakness, the insidious development of respiratory failure and episodes of exacerbation.Material and methodsThe present study involved three patients with severe neuromuscular disease, chronic respiratory failure and long-term mechanical ventilation, who were followed up using a telemedicine platform. The telemedicine system is based on videoconferencing and telemonitoring of cardiorespiratory variables (oxygen saturation, heart rate, blood pressure and electrocardiogram). Two different protocols were followed depending on whether the patient condition was stable or unstable.ResultsOver a period of 5 years, we analyzed a series of variables including use of the system, patient satisfaction and clinical impact. Overall we performed 290 videoconference sessions, 269 short monitoring oximetry measurements and 110 blood pressure measurements. With respect to the clinical impact, after enrolment in the telemedicine program, the total number of hospital admissions fell from 18 to 3.ConclusionsOur findings indicate that the system was user friendly for patients and care givers. Patient satisfaction scores were acceptable. The telemedicine system was effective for the home treatment of three patients with severe neuromuscular diseases and reduced the need for hospital admissions.

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Telehealthcare for chronic obstructive pulmonary disease

Cited by 159 publications

References 60 publications

Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses

Assessment of the Cost-Effectiveness and Clinical Outcomes of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease

– New methods Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure

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