title: A small-scale randomised controlled trial of home telemonitoring in patients with severe chronic obstructive pulmonary disease.
abstract: Introduction This was a pilot study to examine the effects of home telemonitoring (TM) of patients with severe chronic obstructive pulmonary disease (COPD). Methods A randomised controlled 12-month trial of 42 patients with severe COPD was conducted. Home TM of oximetry, temperature, pulse, electrocardiogram, blood pressure, spirometry, and weight with telephone support and home visits was tested against a control group receiving only identical telephone support and home visits. Results The results suggest that TM had a reduction in COPD-related admissions, emergency department presentations, and hospital bed days. TM also seemed to increase the interval between COPD-related exacerbations requiring a hospital visit and prolonged the time to the first admission. The interval between hospital visits was significantly different between the study arms, while the other findings did not reach significance and only suggest a trend. There was a reduction in hospital admission costs. TM was adopted well by most patients and eventually, also by the nursing staff, though it did not seem to change patients' psychological well-being. Discussion Ability to draw firm conclusions is limited due to the small sample size. However the trends of reducing hospital visits warrant a larger study of a similar design. When designing such a trial, one should consider the potential impact of the high quality of care already made available to this patient cohort.
authors.affiliation: 1 Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
authors.forename: Tal
authors.initials: T
authors.lastname: Shany
authors.affiliation: 2 School of Medicine, Western Sydney University, Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Hession
authors.affiliation: 3 Business Intelligence Development Solutions, Western Sydney Local Health District, Sydney, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Pryce
authors.affiliation: 4 Respiratory Ambulatory Care, Westmead Hospital, Sydney, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Roberts
authors.affiliation: 5 School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, Australia.
authors.forename: Jim
authors.initials: J
authors.lastname: Basilakis
authors.affiliation: 1 Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Redmond
authors.affiliation: 1 Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Lovell
authors.affiliation: 6 Austrian Institute of Technology, Graz, Austria.
authors.forename: Guenter
authors.initials: G
authors.lastname: Schreier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D001835:Body Weight; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011674:Pulse; D012720:Severity of Illness Index; D013147:Spirometry; D013686:Telemetry / Q000379:methods*; D013689:Telephone
keywords: Home telecare; cost-effectiveness; remote consultation; telemedicine