Effects of telemonitoring in patients with chronic obstructive pulmonary disease.
The objective of this study was to determine the effects of a homebased telemonitoring device, The Health Buddy (HB), on health consumption and health-related quality of life (HRQoL) in patients with moderate to severe chronic obstructive pulmonary disease (COPD). The HB provides daily symptom-surveillance by a case manager and education to enhance disease knowledge and self-management. A nonrandomized controlled multicenter study was established comparing the effectiveness of telemonitoring as an add-on to care as usual with a follow-up of 6 months. Four hospitals took part in the experimental group and 2 hospitals formed an equivalent control group with 59 and 56 patients, respectively. HRQoL was measured by the Clinical COPD Questionnaire. Healthcare consumption was assessed using medical records in the 6 months preceding study entry and during the study. Compared with the control group, the HB group showed a significant decrease in hospital admission rates (HB -0.11 +/- 1.16 vs. control +0.27 +/- 1.0, p = 0.02) and in the total number of exacerbations (HB -0.35 +/- 1.4 vs. control +0.32 +/- 1.2, p = 0.004). There was a tendency toward decreased hospital days and outpatient visits. No significant changes in HRQoL were observed at follow-up between both study groups. Despite inherent limitations of the study, these findings suggest that adopting telemonitoring in everyday clinical practice is feasible and can substantially improve care and decrease healthcare utilization of patients with moderate to severe COPD.
Trappenburg
Jaap C A
JC
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. j.c.a.trappenburg@umcutrecht.nl
Niesink
Anouk
A
de Weert-van Oene
Gerdien H
GH
van der Zeijden
Hans
H
van Snippenburg
Renée
R
Peters
Albert
A
Lammers
Jan-Willem J
JW
Schrijvers
Augustinus J P
AJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D015438:Health Behavior; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000188:drug therapy / Q000503:physiopathology; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires; D013686:Telemetry / Q000295:instrumentation / Q000706:statistics & numerical data*
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents