title: A systematic review of the cost and cost-effectiveness of telehealth for patients suffering from chronic obstructive pulmonary disease.
abstract: We conducted a systematic review of the evidence on the costs and cost-effectiveness of telehealth for patients with chronic obstructive pulmonary disease (COPD). A literature search identified six relevant economic evaluations that were assessed according to the Consensus Health Economic Criteria list (CHEC list). Three studies were from North America and three studies were from Europe. All studies reported the use of home monitoring devices that measured and transmitted different physical indicators to nurses who provided personalised feedback to patients during weekdays. The six studies involved a total of 559 COPD patients of whom 281 were randomised to telehealth. The review demonstrated a potential for cost savings. All six studies reported a lower average cost per patient with telehealth plus usual care compared with usual care alone. However, the quality of the economic evidence was poor. Five studies were evaluated as low quality and one study was evaluated as moderate quality, with CHEC list scores of 21-68%. Caution is advised for healthcare decision-makers seeking large-scale implementation of telehealth in routine clinical practice. The clinical effectiveness of such implementations with follow-up exceeding 12 months has not yet been demonstrated.
authors.affiliation: Danish Centre for Healthcare Improvements, Faculty of Social Sciences and Faculty of Medicine, Aalborg University, Denmark fwu@business.aau.dk.
authors.forename: Flemming W
authors.initials: FW
authors.lastname: Udsen
authors.affiliation: Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Hejlesen
authors.affiliation: Danish Centre for Healthcare Improvements, Faculty of Social Sciences and Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Ehlers