Using preventive home monitoring to reduce hospital admission rates and reduce costs: a case study of telehealth among chronic obstructive pulmonary disease patients

Dinesen, Birthe; Hæsum, Lisa Korsbakke Emtekær; Soerensen, Natascha; Nielsen, Claus Vinther; Grann, Ove; Hejlesen, Ole; Toft, Egon; Ehlers, Lars Holger

doi:10.1258/jtt.2012.110704

Cited by 115 publications

(130 citation statements)

References 10 publications

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“…122 Patients were recruited from a health center, a general practice, and a pulmonary hospital ward. Both intervention and control groups were observed over a 10-month period.…”

Section: Effects Of Telepulmonology On Use Of Servicementioning

confidence: 99%

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

Bashshur

Shannon

Smith

et al. 2014

Telemedicine and e-Health

309

210

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The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/readmissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.

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“…122 Patients were recruited from a health center, a general practice, and a pulmonary hospital ward. Both intervention and control groups were observed over a 10-month period.…”

Section: Effects Of Telepulmonology On Use Of Servicementioning

confidence: 99%

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

Bashshur

Shannon

Smith

et al. 2014

Telemedicine and e-Health

309

210

View full text Add to dashboard Cite

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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 meta-analysis examining 80 studies suggested that there is no conclusive evidence that such interventions are cost effective (Mistry, 2012). Another study suggested that remote monitoring was not cost effective in reducing hospital costs in patients with chronic obstructive pulmonary disease (Dinesen et al, 2012).…”

Section: Cost 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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Using preventive home monitoring to reduce hospital admission rates and reduce costs: a case study of telehealth among chronic obstructive pulmonary disease patients

Cited by 115 publications

References 10 publications

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

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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