title: Systematic review and meta-analysis of studies involving telehome monitoring-based telenursing for patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  This systematic review evaluated the effects of telehome monitoring-based telenursing (THMTN) on health outcomes and use of healthcare services and compared them with the effects of conventional treatment in patients with severe and very severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  An extensive published work search of several databases was performed in May and October 2011. Randomized controlled trials and non-randomized controlled clinical trials were evaluated. Parameters included hospitalization rate, number of visits to the emergency department, exacerbations, mean number of hospitalizations, mean duration of bed days of care, mortality, and health-related quality of life by the duration of THMTN and COPD severity. A random effects model was applied. Risk ratio and mean difference were calculated. Heterogeneity was assessed using the I(2) statistic.
  
  
  RESULTS
  Nine original articles involving 550 participants were identified in the meta-analysis. THMTN decreased hospitalization rates, emergency department visits, exacerbations, mean number of hospitalizations, and mean duration of bed days of care in severe and very severe COPD patients. Hospitalization rates and emergency department visits were comparable between patients undergoing THMTN of different durations. In addition, THMTN had no effect on mortality.
  
  
  CONCLUSIONS
  THMTN significantly decreases the use of healthcare services; however, it does not affect mortality in severe and very severe COPD patients.
authors.affiliation: St Luke's College of Nursing, Gerontological Nursing, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kamei
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kajii
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kawakami
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006699:Home Care Services / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008991:Monitoring, Physiologic / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing* / Q000503:physiopathology; D012720:Severity of Illness Index; D017216:Telemedicine
keywords: chronic obstructive pulmonary disease; meta-analysis; telehome monitoring; telenursing