title: A randomised trial of telemedicine-based treatment versus conventional hospitalisation in patients with severe COPD and exacerbation - effect on self-reported outcome.
abstract: We investigated self-reported outcome in patients with COPD and exacerbation. Consecutive patients were randomised to an intervention group with home telemedicine and a control group who had conventional hospital admission. We assessed Health-Related Quality of Life (HRQoL) using the St George's Respiratory Questionnaire, daily activity using Instrumental Activity of Daily Living, anxiety and depression using the Hospital Anxiety and Depression Scale, and self-assessed cognitive decline using Subjective Cognitive Functioning. Data were collected at 3 days, 6 weeks and 3 months after discharge. There were 22 patients in each group. Their baseline characteristics were similar: a mean age of 70 years, FEV142% predicted and oxygen saturation 95%. After 6 weeks, FEV1had improved in both groups, to 1.2 L in the intervention group and 1.0 L in the control group. Oxygen saturation had improved in the intervention group from 94% to 96%. Regarding HRQoL, there was a non-significant (P = 0.05) improvement in the symptom score in favour of the control group, but the improvement was not maintained after three months. However, there were no significant differences in self-reported outcomes in COPD patients with exacerbation treated at home via telemedicine versus conventionally in hospital.
authors.affiliation: Telemedicine Research Unit, Frederiksberg University Hospital, Copenhagen, Denmark loneschou@yahoo.dk.
authors.forename: Lone
authors.initials: L
authors.lastname: Schou
authors.affiliation: Research Unit of Nursing, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Birte
authors.initials: B
authors.lastname: Østergaard
authors.affiliation: Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.
authors.forename: Susan
authors.initials: S
authors.lastname: Rydahl-Hansen
authors.affiliation: Department of Anesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University Hospital of Copenhagen, Østerbro, Denmark.
authors.forename: Lars S
authors.initials: LS
authors.lastname: Rasmussen
authors.affiliation: Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Emme
authors.affiliation: Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.
authors.forename: Anna Svarre
authors.initials: AS
authors.lastname: Jakobsen
authors.affiliation: Telemedicine Research Unit, Frederiksberg University Hospital, Copenhagen, Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: Phanareth
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D049269:Videoconferencing