title: Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study.
abstract: The increasing prevalence and associated cost of treating Chronic Obstructive Pulmonary Disease (COPD) is unsustainable, and focus is needed on self-management and prevention of hospital admissions. Telehealth monitoring of patients' vital signs allows clinicians to prioritise their workload and enables patients to take more responsibility for their health. This paper reports the results of a qualitative study embedded within a feasibility and pilot Randomised Controlled Trial (RCT) of Telehealth-supported care within a community-based COPD supported-discharge service. The aim of the study was to qualitatively explore the experiences of patients with COPD who had received either a Telehealth-supported or a specialist nursing intervention following their discharge from hospital after an admission for a COPD exacerbation.
  
  
  
  Patients were invited to either participate in semi-structured interviews or to complete a semi-structured self-administered questionnaire on completion of the intervention. Nine patients were interviewed (67 % female) and seventeen patients completed the questionnaires. In addition, three clinicians responsible for the delivery of both interventions were interviewed to obtain their perspectives on the new services.
  
  
  
  Seven underlying themes emerged from the patient interviews and were further explored in the questionnaires: (1) patient demographics; (2) information received by the participants; (3) installation of the Telehealth technology; (4) Telehealth service functionality; (5) visits; (6) service withdrawal; and (7) service perceptions. Recipients of both services reported feelings of safety derived from the delivery of an integrated, community-based service.
  
  
  
  Although recipients of the Telehealth service received 50 % fewer home visits from the clinicians than recipients of a more traditional community-based nursing intervention, the patients were enthusiastic about the service, with some describing it as the best service they had ever received. This suggests that a Telehealth intervention is an acceptable alternative to a more traditional home nursing visit model for monitoring community-based patients with COPD following their discharge from hospital.
  
  
  
  Current Controlled Trials ISRCTN68856013.
authors.affiliation: School of Health Studies, Western University, Arthur and Sonia Labatt Health Sciences Building, London, Ontario, N6A 3B4, Canada. dfitzsi4@uwo.ca.|School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. dfitzsi4@uwo.ca.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Fitzsimmons
authors.affiliation: School of Nursing and Midwifery, The University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Thompson
authors.affiliation: School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Bentley
authors.affiliation: School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Mountain
mesh_terms: D000359:Aftercare / Q000379:methods; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D036301:Qualitative Research; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D017216:Telemedicine
keywords: COPD; Innovation; Patient-centred care; Qualitative; Technology; Telehealth