title: Randomised crossover trial of telemonitoring  in chronic respiratory patients (TeleCRAFT trial).
abstract: METHODS
  Randomised crossover trial with 6 months of standard best practice clinical care (control group) and 6 months with the addition of telemonitoring.
  
  
  METHODS
  68 patients with chronic lung disease (38 with COPD; 30 with chronic respiratory failure due to other causes), who had a hospital admission for an exacerbation within 6 months of randomisation and either used long-term oxygen therapy or had an arterial oxygen saturation (SpO2) of <90% on air during the previous admission. Individuals received telemonitoring (second-generation system) via broadband link to a hospital-based care team.
  
  
  METHODS
  Primary outcome measure was time to first hospital admission for an acute exacerbation. Secondary outcome measures were hospital admissions, general practitioner (GP) consultations and home visits by nurses, quality of life measured by EuroQol-5D and hospital anxiety and depression (HAD) scale, and self-efficacy score (Stanford).
  
  
  RESULTS
  Median (IQR) number of days to first admission showed no difference between the two groups—77 (114) telemonitoring, 77.5 (61) control ( p=0.189). Hospital admission rate at 6 months increased (0.63 telemonitoring vs 0.32 control p=0.026). Home visits increased during telemonitoring; GP consultations were unchanged. Self-efficacy fell, while HAD depression score improved marginally during telemonitoring.
  
  
  CONCLUSIONS
  Telemonitoring added to standard care did not alter time to next acute hospital admission, increased hospital admissions and home visits overall, and did not improve quality of life in chronic respiratory patients.
  
  
  BACKGROUND
  NCT02180919 (ClinicalTrials.gov).
authors.forename: M
authors.initials: M
authors.lastname: Chatwin
authors.forename: G
authors.initials: G
authors.lastname: Hawkins
authors.forename: L
authors.initials: L
authors.lastname: Panicchia
authors.forename: A
authors.initials: A
authors.lastname: Woods
authors.forename: A
authors.initials: A
authors.lastname: Hanak
authors.forename: R
authors.initials: R
authors.lastname: Lucas
authors.forename: E
authors.initials: E
authors.lastname: Baker
authors.forename: E
authors.initials: E
authors.lastname: Ramhamdany
authors.forename: B
authors.initials: B
authors.lastname: Mann
authors.forename: J
authors.initials: J
authors.lastname: Riley
authors.forename: M R
authors.initials: MR
authors.lastname: Cowie
authors.forename: A K
authors.initials: AK
authors.lastname: Simonds
mesh_terms: D000368:Aged; D002908:Chronic Disease; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000628:therapy*; D012307:Risk Factors; D017216:Telemedicine; D016896:Treatment Outcome