Telemonitoring Interventions in COPD Patients: Overview of Systematic Reviews

Abstract

Objective. The role of telemonitoring interventions (TIs) for chronic obstructive pulmonary disease (COPD) has been studied in many systematic reviews (SRs) and meta-analyses (MAs), but robust conclusions have not been reached due to wide variations in scopes, qualities, and outcomes. The aim of this overview was to determine the effectiveness of TIs on COPD patients. Methods. PubMed, EMBASE, Web of Science, and Cochrane Library were searched for all reviews on the topic of TI in treating COPD from inception to July 8, 2019, without restrictions on language. According to the inclusion and exclusion criteria, the retrieved literature studies were screened to select SRs and MAs of randomized control trials (RCTs) that evaluated the effects of TIs in COPD patients. The methodological quality of SRs and MAs was assessed with the AMSTAR-2 tool, and the strength of evidence was assessed with the grades of recommendations, assessment, development, and evaluation (GRADE) system for concerned outcomes in terms of mortality, quality of life (SGRQ total scores), exercise capacity (6MWD), and exacerbation-related outcomes (hospitalizations, exacerbation rate, and emergency room visits). Results. Our overview included eight SRs and MAs published in 2011 to 2019, from 95 RCTs involving 10632 participants. After strict evaluation by the AMSTAR-2 tool, 75% of the SRs and MAs in this overview had either low or critically low methodological quality. The effects of TIs for COPD on mortality, quality of life, exercise capacity, and exacerbation-related outcomes are limited, and all of these outcomes scored either low or very low quality of evidence on the GRADE system. Conclusions. There might be insufficient evidence to support the effectiveness of TIs for COPD currently, but the results of this overview should be interpreted dialectically and prudently, and the role of TIs in COPD needs further exploration.

Telemedicine in COPD: An Overview by Topics

“…Vianello, A., et al contradicts this information, with negative results in quality of life and a RCT with 578 patients intervened by Lilholt PH, et al exposed a non-superior health-related quality of life in a 12-months follow-up [32,33]. Other data suggests it might not have impact in reducing mortality and exacerbation-related outcomes in COPD [35], with others showing reticence regarding the application of these interventions in a generalized way (34), stating that the benefits might come from the fact that patients submitted to clinical trials have more attention and support with the disease than otherwise they would receive. Few reports also established positive results and possibilities for the successful application of telemonitoring interventions: with regard to noninvasive ventilation [38] forced expiratory volume [39], peripheral oxygen saturation [28,29,42] and physical activity [12].…”

“…Concerning mortality rates, a recent 12-months RCT by Kessler, R., et al [18] revealed a reduced acute care hospitalization days and mortality rate in severe COPD patients. Nevertheless, four reviews stated that telemonitoring and tele-health programs failed to significantly reduce mortality [24,26,35,41]. In addition to usual care, patients in the intervention group received a set of telehealth care equipment and were monitored by a community-based healthcare team.…”

Telemonitoreo de pacientes con enfermedades avanzadas no curables: Revisión narrativa y experiencia inicial en el programa de visita domiciliar del Centro Nacional de Control del Dolor y Cuidados Paliativos durante la emergencia nacional relacionada con C

“…Existen estudios que han demostrado resultados positivos en pacientes enfermedades crónicas progresivas como falla cardiaca (10,11). Enfermedad Pulmonar Obstructiva Crónica (12), hepatopatía crónica(13) así como en pacientes con cáncer (14,15). Esfuerzos anecdóticos recientes están evaluando esta tecnología para comunidades rurales (16).…”

Workshops as Tools for Developing Collaborative Practice across Professional Social Worlds in Telemonitoring

“…Healthcare increasingly embraces technologies introduced to ease, reorganize, or streamline a specific task; for instance, measurements and devices in telemonitoring [ 4 , 5 , 6 ]. When appropriate, such technologies constitute powerful tools for self-surveillance, education, and self-reliance [ 7 , 8 ].…”