title: A telehealth program for self-management of COPD exacerbations and promotion of an active lifestyle: a pilot randomized controlled trial.
abstract: The objective of this pilot study was to investigate the use of and satisfaction with a chronic obstructive pulmonary disease (COPD) telehealth program applied in both primary and secondary care. The program consisted of four modules: 1) activity coach for ambulant activity monitoring and real-time coaching of daily activity behavior, 2) web-based exercise program for home exercising, 3) self-management of COPD exacerbations via a triage diary on the web portal, including self-treatment of exacerbations, and 4) teleconsultation. Twenty-nine COPD patients were randomly assigned to either the intervention group (telehealth program for 9 months) or the control group (usual care). Page hits on the web portal showed the use of the program, and the Client Satisfaction Questionnaire showed satisfaction with received care. The telehealth program with decision support showed good satisfaction (mean 26.4, maximum score 32). The program was accessed on 86% of the treatment days, especially the diary. Patient adherence with the exercise scheme was low (21%). Health care providers seem to play an important role in patients' adherence to telehealth in usual care. Future research should focus on full-scale implementation in daily care and investigating technological advances, like gaming, to increase adherence.
authors.affiliation: Telemedicine Group, Roessingh Research and Development, Enschede, the Netherlands ; Telemedicine Group, University of Twente, Enschede, the Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Tabak
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Brusse-Keizer
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands ; Medical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.affiliation: Telemedicine Group, Roessingh Research and Development, Enschede, the Netherlands ; Telemedicine Group, University of Twente, Enschede, the Netherlands.
authors.forename: Hermie
authors.initials: H
authors.lastname: Hermens
authors.affiliation: Telemedicine Group, Roessingh Research and Development, Enschede, the Netherlands ; Telemedicine Group, University of Twente, Enschede, the Netherlands.
authors.forename: Miriam
authors.initials: M
authors.lastname: Vollenbroek-Hutten
mesh_terms: D000368:Aged; D003376:Counseling; D018450:Disease Progression; D017079:Exercise Tolerance; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009426:Netherlands; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010865:Pilot Projects; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D040242:Risk Reduction Behavior; D063127:Secondary Health Care; D012648:Self Care; D017216:Telemedicine; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
keywords: COPD; exacerbations; physical activity; self-management; telehealth