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Glyde HMG, Morgan C, Wilkinson TMA, Nabney IT, Dodd JW. Remote Patient Monitoring and Machine Learning in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Dual Systematic Literature Review and Narrative Synthesis. J Med Internet Res 2024; 26:e52143. [PMID: 39250789 DOI: 10.2196/52143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/29/2024] [Accepted: 07/09/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with high mortality, morbidity, and poor quality of life and constitute a substantial burden to patients and health care systems. New approaches to prevent or reduce the severity of AECOPD are urgently needed. Internationally, this has prompted increased interest in the potential of remote patient monitoring (RPM) and digital medicine. RPM refers to the direct transmission of patient-reported outcomes, physiological, and functional data, including heart rate, weight, blood pressure, oxygen saturation, physical activity, and lung function (spirometry), directly to health care professionals through automation, web-based data entry, or phone-based data entry. Machine learning has the potential to enhance RPM in chronic obstructive pulmonary disease by increasing the accuracy and precision of AECOPD prediction systems. OBJECTIVE This study aimed to conduct a dual systematic review. The first review focuses on randomized controlled trials where RPM was used as an intervention to treat or improve AECOPD. The second review examines studies that combined machine learning with RPM to predict AECOPD. We review the evidence and concepts behind RPM and machine learning and discuss the strengths, limitations, and clinical use of available systems. We have generated a list of recommendations needed to deliver patient and health care system benefits. METHODS A comprehensive search strategy, encompassing the Scopus and Web of Science databases, was used to identify relevant studies. A total of 2 independent reviewers (HMGG and CM) conducted study selection, data extraction, and quality assessment, with discrepancies resolved through consensus. Data synthesis involved evidence assessment using a Critical Appraisal Skills Programme checklist and a narrative synthesis. Reporting followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS These narrative syntheses suggest that 57% (16/28) of the randomized controlled trials for RPM interventions fail to achieve the required level of evidence for better outcomes in AECOPD. However, the integration of machine learning into RPM demonstrates promise for increasing the predictive accuracy of AECOPD and, therefore, early intervention. CONCLUSIONS This review suggests a transition toward the integration of machine learning into RPM for predicting AECOPD. We discuss particular RPM indices that have the potential to improve AECOPD prediction and highlight research gaps concerning patient factors and the maintained adoption of RPM. Furthermore, we emphasize the importance of a more comprehensive examination of patient and health care burdens associated with RPM, along with the development of practical solutions.
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Affiliation(s)
- Henry Mark Granger Glyde
- EPSRC Centre for Doctoral Training in Digital Health and Care, University of Bristol, Bristol, United Kingdom
| | - Caitlin Morgan
- Academic Respiratory Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tom M A Wilkinson
- Clinical and Experimental Science, University of Southampton, Southampton, United Kingdom
| | - Ian T Nabney
- School of Engineering and Mathematics, University of Bristol, Bristol, United Kingdom
| | - James W Dodd
- Academic Respiratory Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Chang H, Zhou J, Chen Y, Wang X, Wang Z. Comparative effectiveness of eHealth interventions on the exercise endurance and quality of life of patients with COPD: A systematic review and network meta-analysis. J Clin Nurs 2024; 33:3711-3720. [PMID: 38937908 DOI: 10.1111/jocn.17225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/25/2024] [Accepted: 05/13/2024] [Indexed: 06/29/2024]
Abstract
AIMS To compare the effectiveness of different types of eHealth interventions in improving exercise endurance and quality of life in chronic obstructive pulmonary disease (COPD) patients. BACKGROUND COPD is a chronic airway disease characterized by persistent respiratory symptoms and airflow limitation. eHealth interventions have been accepted and recognized by healthcare professionals and COPD patients as an effective alternative to pulmonary rehabilitation. However, it is not clear which eHealth interventions are effective and preferred for exercise endurance and quality of life in COPD patients. DESIGN A systematic review and network meta-analysis based on PRISMA-NMA. METHODS We searched nine electronic databases to identify randomized controlled trials addressing the effect of eHealth interventions on the exercise endurance and quality of life of COPD patients from their inception to 30 October 2022. First, a random-effects model was chosen to conduct a traditional meta-analysis to directly investigate the efficacy of different eHealth interventions. Next, a network meta-analysis was performed to evaluate the relative efficacy of the eHealth interventions for COPD. The quality of the data was assessed using the Cochrane Risk of Bias tool. RESULTS Fifty-one studies containing six eHealth interventions (telemonitoring, application [APP], web-based interventions, phone calls, virtual reality and combined interventions [≥two types]) were included in the final analysis. Network meta-analysis showed that telemonitoring, APP, web-based interventions and combined interventions improved exercise endurance in COPD patients, with telemonitoring being the most effective. Web-based interventions and apps are effective in improving the quality of life, and web-based interventions are the most effective. CONCLUSIONS This study confirms that eHealth interventions can improve exercise endurance and quality of life in COPD patients. In the future, healthcare professionals can promote the use of telemedicine in COPD patients to enhance their exercise endurance and quality of life according to their individual needs. RELEVANCE TO CLINICAL PRACTICE This evidence suggests that eHealth interventions can improve exercise endurance and quality of life in COPD patients. Therefore, in the future, eHealth interventions could be used to maximize their effectiveness in improving exercise endurance and quality of life in COPD patients.
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Affiliation(s)
- Hui Chang
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Jia Zhou
- School of Nursing, Peking University, Beijing, China
| | - Yundi Chen
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Xiuhong Wang
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Schoevaerdts D, Lerude MP, Tellier V, Pierard M, Voilmy D, Novella JL. Home telemonitoring in smart rurality: results from the HIS2R interreg feasibility pilot study. Aging Clin Exp Res 2024; 36:67. [PMID: 38480582 PMCID: PMC10937768 DOI: 10.1007/s40520-024-02709-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/23/2024] [Indexed: 03/17/2024]
Abstract
AIMS The Health in Smart Rurality Interreg project aims to assess the feasibility of telemonitoring in rural areas across the Franco-Belgian border among patients affected by heart failure or chronic obstructive pulmonary disease. The objectives were to better understand strengths or barriers to implementing telemonitoring for early detection of potential adverse events, for improving quality of life, communication, and care coordination. METHODS Using a prospective 6-month observational design, interconnected pads were provided to community-dwelling adults aged over 60 years. The device monitored daily body weight, temperature, cardiac rate, blood pressure, and oxygen saturation. Using predefined warning thresholds, data were analyzed by a nurse case-manager who also provided therapeutic education during their contacts. RESULTS Out of 87 eligible and screened patients, 21 (24%) were included in the study. At the end of the follow-up, 19 patients (90%) were re-assessed. The rate of hospitalization and mortality was high (32% and 10%, respectively). A total of 644 alerts were recorded (median of 29 alerts/patients) with a high rate of technically-related alerts (TRA) (26%). Out of the 475 non-TRA, 79% and 1% have led to an intervention by the case-manager or the physician, respectively. Therapeutic adjustment was proposed for 12 patients during that period. CONCLUSION Telemonitoring appears to be a promising solution for the follow-up of patients living far from medical resources. The contribution of a case-manager is of added-value in managing alerts, therapeutic education, and coaching. Many questions remain open such as the improvement of technical aspects and long-term compliance in a real-world setting.
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Affiliation(s)
- Didier Schoevaerdts
- Department of Geriatric Medicine, CHU UCL Namur, Institute of Health and Society, Catholic University of Louvain, Avenue Dr Gaston Thérasse, 1, 5530, Yvoir, Belgium.
| | - Marie-Paule Lerude
- Public Health Department, Province de Namur, Place Saint Aubain, 2, 5000, Namur, Belgium
| | - Véronique Tellier
- Public Health Department, Province de Namur, Place Saint Aubain, 2, 5000, Namur, Belgium.
| | - Marie Pierard
- Fédération des Centres de Services à Domicile - FCSD, Rue de Gembloux 196, 5002, Namur, Belgium
| | - Dimitri Voilmy
- Laboratoire Informatique et Société Numérique-Équipe Modélisation et Sûreté des Systèmes, Université de technologie de Troyes, Rue Marie Curie, 12, 10300, Troyes, France
| | - Jean-Luc Novella
- Department of Geriatric Medicine, CHU Reims, Hôpital Maison Blanche, rue Cognacq Jay 45, 51100, Reims, France
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Dervieux E, Guerrero F, Uhring W, Giroux-Metgès MA, Théron M. Skin temperature influence on transcutaneous carbon dioxide (CO 2) conductivity and skin blood flow in healthy human subjects at the arm and wrist. Front Physiol 2024; 14:1293752. [PMID: 38321986 PMCID: PMC10846589 DOI: 10.3389/fphys.2023.1293752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 02/08/2024] Open
Abstract
Objective: present transcutaneous carbon dioxide (CO2)-tcpCO2-monitors suffer from limitations which hamper their widespread use, and call for a new tcpCO2 measurement technique. However, the progress in this area is hindered by the lack of knowledge in transcutaneous CO2 diffusion. To address this knowledge gap, this study focuses on investigating the influence of skin temperature on two key skin properties: CO2 permeability and skin blood flow. Methods: a monocentric prospective exploratory study including 40 healthy adults was undertaken. Each subject experienced a 90 min visit split into five 18 min sessions at different skin temperatures-Non-Heated (NH), 35, 38, 41, and 44°C. At each temperature, custom sensors measured transcutaneous CO2 conductivity and exhalation rate at the arm and wrist, while Laser Doppler Flowmetry (LDF) assessed skin blood flow at the arm. Results: the three studied metrics sharply increased with rising skin temperature. Mean values increased from the NH situation up to 44°C from 4.03 up to 8.88 and from 2.94 up to 8.11 m·s-1 for skin conductivity, and from 80.4 up to 177.5 and from 58.7 up to 162.3 cm3·m-2·h-1 for exhalation rate at the arm and wrist, respectively. Likewise, skin blood flow increased elevenfold for the same temperature increase. Of note, all metrics already augmented significantly in the 35-38°C skin temperature range, which may be reached without active heating-i.e. only using a warm clothing. Conclusion: these results are extremely encouraging for the development of next-generation tcpCO2 sensors. Indeed, the moderate increase (× 2) in skin conductivity from NH to 44°C tends to indicate that heating the skin is not critical from a response time point of view, i.e. little to no skin heating would only result in a doubled sensor response time in the worst case, compared to a maximal heating at 44°C. Crucially, a skin temperature within the 35-38°C range already sharply increases the skin blood flow, suggesting that tcpCO2 correlates well with the arterial paCO2 even at such low skin temperatures. These two conclusions further strengthen the viability of non-heated tcpCO2 sensors, thereby paving the way for the development of wearable transcutaneous capnometers.
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Affiliation(s)
- Emmanuel Dervieux
- Biosency, Cesson-Sévigné, France
- EA4324-ORPHY, Univ Brest, Brest, France
- ICube, University of Strasbourg and CNRS, Strasbourg, France
| | | | - Wilfried Uhring
- ICube, University of Strasbourg and CNRS, Strasbourg, France
| | - Marie-Agnès Giroux-Metgès
- EA4324-ORPHY, Univ Brest, Brest, France
- Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
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Kim EK, Lee E, Park JE, Lee JS, Choi HS, Park B, Sheen SS, Park KJ, Rhee CK, Lee SY, Yoo KH, Park JH. Cardiovascular Events According to Inhaler Therapy and Comorbidities in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:243-254. [PMID: 38269030 PMCID: PMC10806337 DOI: 10.2147/copd.s433583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background COPD coexists with many concurrent comorbidities. Cardiovascular complications are deemed to be major causes of death in COPD. Although inhaler therapy is the main therapeutic intervention in COPD, cardiovascular events accompanying inhaler therapy require further investigation. Therefore, this study aimed to investigate new development of cardiovascular events according to each inhaler therapy and comorbidities. Methods This study analyzed COPD patients (age ≥ 40 years, N = 199,772) from the Health Insurance Review and Assessment Service (HIRA) database in Korea. The development of cardiovascular events, from the index date to December 31, 2020, was investigated. The cohort was eventually divided into three arms: the LAMA/LABA group (N = 28,322), the ICS/LABA group (N = 11,812), and the triple group (LAMA/ICS/LABA therapy, N = 6174). Results Multivariable Cox analyses demonstrated that, compared to ICS/LABA therapy, triple therapy was independently associated with the development of ischemic heart disease (HR: 1.22, 95% CI: 1.04-1.43), heart failure (HR: 1.45, 95% CI: 1.14-1.84), arrhythmia (HR: 1.72, 95% CI: 1.41-2.09), and atrial fibrillation/flutter (HR: 2.31, 95% CI: 1.64-3.25), whereas the LAMA/LABA therapy did not show a significant association. Furthermore, emergency room visit during covariate assessment window was independently associated with the development of ischemic heart disease, heart failure, arrhythmia, and atrial fibrillation/flutter (p < 0.05). Conclusion Our data suggest that cardiovascular risk should be considered in COPD patients receiving triple therapy, despite the confounding bias resulting from disparities in each group.
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Affiliation(s)
- Eun Kyung Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Eunyoung Lee
- Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Ji Eun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae Seung Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Sook Choi
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Bumhee Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kwang Joo Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Chin Kook Rhee
- Department of Internal Medicine, Seoul St. Mary’s Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Yeub Lee
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Joo Hun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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Matthias K, Honekamp I, Heinrich M, De Santis KK. Consideration of Sex, Gender, or Age on Outcomes of Digital Technologies for Treatment and Monitoring of Chronic Obstructive Pulmonary Disease: Overview of Systematic Reviews. J Med Internet Res 2023; 25:e49639. [PMID: 38019578 PMCID: PMC10719824 DOI: 10.2196/49639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Several systematic reviews have addressed digital technology use for treatment and monitoring of chronic obstructive pulmonary disease (COPD). OBJECTIVE This study aimed to assess if systematic reviews considered the effects of sex, gender, or age on the outcomes of digital technologies for treatment and monitoring of COPD through an overview of such systematic reviews. The objectives of this overview were to (1) describe the definitions of sex or gender used in reviews; (2) determine whether the consideration of sex, gender, or age was planned in reviews; (3) determine whether sex, gender, or age was reported in review results; (4) determine whether sex, gender, or age was incorporated in implications for clinical practice in reviews; and (5) create an evidence map for development of individualized clinical recommendations for COPD based on sex, gender, or age diversity. METHODS MEDLINE, the Cochrane Library, Epistemonikos, Web of Science, and the bibliographies of the included systematic reviews were searched to June 2022. Inclusion was based on the PICOS framework: (1) population (COPD), (2) intervention (any digital technology), (3) comparison (any), (4) outcome (any), and (5) study type (systematic review). Studies were independently selected by 2 authors based on title and abstract and full-text screening. Data were extracted by 1 author and checked by another author. Data items included systematic review characteristics; PICOS criteria; and variables related to sex, gender, or age. Systematic reviews were appraised using A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2). Data were synthesized using descriptive statistics. RESULTS Of 1439 records, 30 systematic reviews published between 2010 and 2022 were included in this overview. The confidence in the results of 25 of the 30 (83%) reviews was critically low according to AMSTAR 2. The reviews focused on user outcomes that potentially depend on sex, gender, or age, such as efficacy or effectiveness (25/30, 83%) and acceptance, satisfaction, or adherence (3/30, 10%) to digital technologies for COPD. Reviews reported sex or gender (19/30 systematic reviews) or age (25/30 systematic reviews) among primary study characteristics. However, only 1 of 30 reviews included age in a subgroup analysis, and 3 of 30 reviews identified the effects of sex, gender, or age as evidence gaps. CONCLUSIONS This overview shows that the effects of sex, gender, or age were rarely considered in 30 systematic reviews of digital technologies for COPD treatment and monitoring. Furthermore, systematic reviews did not incorporate sex, gender, nor age in their implications for clinical practice. We recommend that future systematic reviews should (1) evaluate the effects of sex, gender, or age on the outcomes of digital technologies for treatment and monitoring of COPD and (2) better adhere to reporting guidelines to improve the confidence in review results. TRIAL REGISTRATION PROSPERO CRD42022322924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322924. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/40538.
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Affiliation(s)
- Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Ivonne Honekamp
- Faculty of Business, University of Applied Science Stralsund, Stralsund, Germany
| | - Monique Heinrich
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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de Bell S, Zhelev Z, Shaw N, Bethel A, Anderson R, Thompson Coon J. Remote monitoring for long-term physical health conditions: an evidence and gap map. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-74. [PMID: 38014553 DOI: 10.3310/bvcf6192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Remote monitoring involves the measurement of an aspect of a patient's health without that person being seen face to face. It could benefit the individual and aid the efficient provision of health services. However, remote monitoring can be used to monitor different aspects of health in different ways. This evidence map allows users to find evidence on different forms of remote monitoring for different conditions easily to support the commissioning and implementation of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent systematic reviews on the effectiveness, acceptability and implementation of remote monitoring for adults with long-term physical health conditions. Data sources We searched MEDLINE, nine further databases and Epistemonikos for systematic reviews published between 2018 and March 2022, PROSPERO for continuing reviews, and completed citation chasing on included studies. Review methods (Study selection and Study appraisal): Included systematic reviews focused on adult populations with a long-term physical health condition and reported on the effectiveness, acceptability or implementation of remote monitoring. All forms of remote monitoring where data were passed to a healthcare professional as part of the intervention were included. Data were extracted on the characteristics of the remote monitoring intervention and outcomes assessed in the review. AMSTAR 2 was used to assess quality. Results were presented in an interactive evidence and gap map and summarised narratively. Stakeholder and public and patient involvement groups provided feedback throughout the project. Results We included 72 systematic reviews. Of these, 61 focus on the effectiveness of remote monitoring and 24 on its acceptability and/or implementation, with some reviews reporting on both. The majority contained studies from North America and Europe (38 included studies from the United Kingdom). Patients with cardiovascular disease, diabetes and respiratory conditions were the most studied populations. Data were collected predominantly using common devices such as blood pressure monitors and transmitted via applications, websites, e-mail or patient portals, feedback provided via telephone call and by nurses. In terms of outcomes, most reviews focused on physical health, mental health and well-being, health service use, acceptability or implementation. Few reviews reported on less common conditions or on the views of carers or healthcare professionals. Most reviews were of low or critically low quality. Limitations Many terms are used to describe remote monitoring; we searched as widely as possible but may have missed some relevant reviews. Poor reporting of remote monitoring interventions may mean some included reviews contain interventions that do not meet our definition, while relevant reviews might have been excluded. This also made the interpretation of results difficult. Conclusions and future work The map provides an interactive, visual representation of evidence on the effectiveness of remote monitoring and its acceptability and successful implementation. This evidence could support the commissioning and delivery of remote monitoring interventions, while the limitations and gaps could inform further research and technological development. Future reviews should follow the guidelines for conducting and reporting systematic reviews and investigate the application of remote monitoring in less common conditions. Review registration A protocol was registered on the OSF registry (https://doi.org/10.17605/OSF.IO/6Q7P4). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Services and Delivery Research programme (NIHR award ref: NIHR135450) as part of a series of evidence syntheses under award NIHR130538. For more information, visit https://fundingawards.nihr.ac.uk/award/NIHR135450 and https://fundingawards.nihr.ac.uk/award/NIHR130538. The report is published in full in Health and Social Care Delivery Research; Vol. 11, No. 22. See the NIHR Funding and Awards website for further project information.
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Affiliation(s)
- Siân de Bell
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
| | - Zhivko Zhelev
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis Centre, Department of Health and Community Sciences, Medical School, University of Exeter, Exeter, UK
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Chahdi M, Bruchhäuser A, von Gahlen-Hoops W, Nydahl P. [Interventions to reduce hospital readmission rates in patients with COPD: a systematic review]. Med Klin Intensivmed Notfmed 2023; 118:584-591. [PMID: 37099147 DOI: 10.1007/s00063-023-01003-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) have a high risk of hospital and intensive care unit readmission. Readmissions are a severe burden on patients, families, and the health care system. The aim of this study is to identify pedagogical-counseling interventions to reduce readmissions and other parameters in COPD patients. METHODS A systematic literature search was performed in March 2022 in the databases Medline, Cochrane Library, CINAHL, and LIVIVO. German‑, English‑, Arabic-, and French-language (cluster-) randomized, controlled studies were included. RESULTS In all, 21 studies with a total of 3894 COPD patients were included. The quality of included studies was moderate to good. Interventions were self-management programs, telemedical, and educational interventions. Five out of seven studies found a significant reduction in readmissions for self-management programs (p = 0.02-0.49). A positive effect of telemedicine interventions on outcome parameters was only reported in two studies (p < 0.05) and no significant effect in four studies. Educational interventions were examined in six studies: four found no difference between the study groups and two found a significant difference in favor of the intervention group (p = 0.01). Special care programs also showed a significant effect in two studies. CONCLUSION
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Affiliation(s)
- Mohamed Chahdi
- Gesundheits- und Krankenpfleger, Klinik für Neurologie, Station D110, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland, Arnold-Heller-Str. 3.
| | - Antje Bruchhäuser
- Gesundheits- und Krankenpflegerin, Weaning-Station, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland
| | - Wolfgang von Gahlen-Hoops
- Professur für Didaktik der Pflege und Gesundheitsberufe, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - Peter Nydahl
- Arbeitsgruppe Didaktik in der Pflege, Pflegewissenschaft und -entwicklung, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
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Arnaert A, Ahmed A, Debe Z, Charbonneau S, Paul S. Telehealth nursing interventions for phenotypes of older adults with COPD: an exploratory study. Front Digit Health 2023; 5:1144075. [PMID: 37808916 PMCID: PMC10558261 DOI: 10.3389/fdgth.2023.1144075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 08/01/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Inconclusive results exist around the effectiveness of telemonitoring for patients with COPD, and studies recommended conducting subgroup analyses to identify patient phenotypes that could benefit from these services. This exploratory study investigated what type of COPD patients were receiving which type of telenursing interventions more frequently using the telemonitoring platform. Methods A sample of 36 older adults with COPD were receiving telenursing services for 12 months and were asked to answer five COPD-symptom related questions and submit their vital signs daily. Results Findings revealed two phenotypes of older adults for whom the frequency of telenursing calls and related interventions differed. Although no statistically significant differences were observed in participants' GOLD grades and hospitalizations, cluster one participants used their COPD action plan significantly more frequently, and were in frequent contact with the telenurse. Discussion It is paramount that further research is needed on the development of patient phenotypes who may benefit from telemonitoring.
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Affiliation(s)
- A. Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - A.M.I. Ahmed
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Z. Debe
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - S. Charbonneau
- Montreal West Island Integrated University Health and Social Service Centre, Montreal, QC, Canada
| | - S. Paul
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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Pereira J, Antunes N, Rosa J, Ferreira JC, Mogo S, Pereira M. Intelligent Clinical Decision Support System for Managing COPD Patients. J Pers Med 2023; 13:1359. [PMID: 37763127 PMCID: PMC10532899 DOI: 10.3390/jpm13091359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Health remote monitoring systems (HRMSs) play a crucial role in managing COPD patients by identifying anomalies in their biometric signs and alerting healthcare professionals. By analyzing the relationships between biometric signs and environmental factors, it is possible to develop artificial intelligence models that are capable of inferring patients' future health deterioration risks. In this research work, we review recent works in this area and develop an intelligent clinical decision support system (CIDSS) that is capable of providing early information concerning patient health evolution and risk analysis in order to support the treatment of COPD patients. The present work's CIDSS is composed of two main modules: the vital signs prediction module and the early warning score calculation module, which generate the patient health information and deterioration risks, respectively. Additionally, the CIDSS generates alerts whenever a biometric sign measurement falls outside the allowed range for a patient or in case a basal value changes significantly. Finally, the system was implemented and assessed in a real case and validated in clinical terms through an evaluation survey answered by healthcare professionals involved in the project. In conclusion, the CIDSS proves to be a useful and valuable tool for medical and healthcare professionals, enabling proactive intervention and facilitating adjustments to the medical treatment of patients.
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Affiliation(s)
- José Pereira
- INOV Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal; (J.P.); (N.A.); (J.R.)
- Instituto Universitário de Lisboa (ISCTE-IUL), ISTAR (Information Sciences, Technologies and Architecture Research Center), 1649-026 Lisboa, Portugal
| | - Nuno Antunes
- INOV Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal; (J.P.); (N.A.); (J.R.)
| | - Joana Rosa
- INOV Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal; (J.P.); (N.A.); (J.R.)
| | - João C. Ferreira
- INOV Inesc Inovação—Instituto de Novas Tecnologias, 1000-029 Lisbon, Portugal; (J.P.); (N.A.); (J.R.)
- Instituto Universitário de Lisboa (ISCTE-IUL), ISTAR (Information Sciences, Technologies and Architecture Research Center), 1649-026 Lisboa, Portugal
- Logistics, Molde University College, NO-6410 Molde, Norway
| | - Sandra Mogo
- Departamento de Física, Universidade da Beira Interior, 6201-001 Covilhã, Portugal;
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11
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Gijsbers H, Nurmohamed A, van de Belt TH, Schijven M. The National Coordinated Citrien eHealth Program to Scale Up Telemonitoring: Protocol for a Before-and-After Evaluation Study. JMIR Res Protoc 2023; 12:e45201. [PMID: 37494085 PMCID: PMC10413225 DOI: 10.2196/45201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/24/2023] [Accepted: 05/24/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Sustainable implementation of telemonitoring in health care is challenging, especially if one aims to scale up telemonitoring initiatives nationwide. The National collaborative eHealth program in the Netherlands is supporting the nationwide upscaling of telemonitoring in 3 clinical domains by implementing telemonitoring in all Dutch university medical centers (UMCs). The chosen telemonitoring concepts are (1) telemonitoring solutions in the domain of cardiology, (2) telemonitoring solutions providing care from a distance in obstetrics, and (3) telemonitoring solutions monitoring vital functions in hospital wards. OBJECTIVE The aim of this study is to evaluate the upscaling of telemonitoring in Dutch university hospitals in order to gain a better knowledge of the process, methods, and outcomes of nationwide upscaling strategies. Our hypothesis is that by the completion of the Citrien program's scale-up, telemonitoring will be operational in all UMCs but not normalized in routine care. METHODS A before-and-after study will be conducted to assess upscaling. The theoretical frameworks used are the framework for nonadoption, abandonment, scale-up, spread, and sustainability; the Normalization Process Theory; and a project management tool Project Canvas. The primary outcome of the study is the degree of normalization to which health care providers at UMCs consider telemonitoring a part of their routine practice, measured using the Normalization MeAsurement Development tool (NoMAD). Our secondary outcome is the uptake of telemonitoring at the Dutch UMCs, using management data from UMCs' business intelligence systems query. RESULTS Data will be collected between May 2020 and December 2022. Results were retrieved in June 2023. UMCs' business intelligence systems are queried for data for the secondary outcome measures. There is a risk that the UMCs will not be able to provide this management information. The laws and regulations governing telemonitoring in the Netherlands are changing, with the Electronic Data Exchange in Health Care Act (Wet elektronische gegevensuitwisseling in de zorg) and the European Health Data Space Act expected to positively influence implementation and upscaling. CONCLUSIONS The Citrien program is a nationally coordinated change management program that is scaling up telemonitoring across contexts and settings. This study will produce original data on the uptake and upscaling of telemonitoring at Dutch UMCs. Future initiatives to implement eHealth in the health care sector may be guided by the wide range of success factors, obstacles, and experiences collected through this program. The network itself may be of great value impacting future acceleration of eHealth initiatives. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45201.
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Affiliation(s)
- Harm Gijsbers
- Department of Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
| | - Azam Nurmohamed
- Department of Internal Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, Netherlands
| | - Tom H van de Belt
- Center for Sustainable Healthcare, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Marlies Schijven
- Department of Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
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12
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van den Biggelaar R, Hazenberg A, Duiverman ML. The role of telemonitoring in patients on home mechanical ventilation. Eur Respir Rev 2023; 32:32/168/220207. [PMID: 37019457 PMCID: PMC10074164 DOI: 10.1183/16000617.0207-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 04/07/2023] Open
Abstract
There is a growing number of patients being treated with long-term home mechanical ventilation (HMV). This poses a challenge for the healthcare system because in-hospital resources are decreasing. The application of digital health to assist HMV care might help. In this narrative review we discuss the evidence for using telemonitoring to assist in initiation and follow-up of patients on long-term HMV. We also give an overview of available technology and discuss which parameters can be measured and how often this should be done. To get a telemonitoring solution implemented in clinical practice is often complex; we discuss which factors contribute to that. We discuss patients' opinions regarding the use of telemonitoring in HMV. Finally, future perspectives for this rapidly growing and evolving field will be discussed.
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Affiliation(s)
- Ries van den Biggelaar
- Dept of Pulmonary Diseases/Home Mechanical Ventilation, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Anda Hazenberg
- Dept of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke L Duiverman
- Dept of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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13
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An Q, Sandlund M, Agnello D, McCaffrey L, Chastin S, Helleday R, Wadell K. A scoping review of co-creation practice in the development of non-pharmacological interventions for people with Chronic Obstructive Pulmonary Disease: A health CASCADE study. Respir Med 2023; 211:107193. [PMID: 36889517 DOI: 10.1016/j.rmed.2023.107193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/28/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Incorporating co-creation processes may improve the quality of outcome interventions. However, there is a lack of synthesis of co-creation practices in the development of Non-Pharmacological Interventions (NPIs) for people with Chronic Obstructive Pulmonary Disease (COPD), that could inform future co-creation practice and research for rigorously improving the quality of care. OBJECTIVE This scoping review aimed to examine the co-creation practice used when developing NPIs for people with COPD. METHODS This review followed Arksey and O'Malley scoping review framework and was reported according to the PRISMA-ScR framework. The search included PubMed, Scopus, CINAHL, and Web of Science Core Collection. Studies reporting on the process and/or analysis of applying co-creation practice in developing NPIs for people with COPD were included. RESULTS 13 articles complied with the inclusion criteria. Limited creative methods were reported in the studies. Facilitators described in the co-creation practices included administrative preparations, diversity of stakeholders, cultural considerations, employment of creative methods, creation of an appreciative environment, and digital assistance. Challenges around the physical limitations of patients, the absence of key stakeholder opinions, a prolonged process, recruitment, and digital illiteracy of co-creators were listed. Most of the studies did not report including implementation considerations as a discussion point in their co-creation workshops. CONCLUSION Evidence-based co-creation in COPD care is critical for guiding future practice and improving the quality of care delivered by NPIs. This review provides evidence for improving systematic and reproducible co-creation. Future research should focus on systematically planning, conducting, evaluating, and reporting co-creation practices in COPD care.
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Affiliation(s)
- Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden.
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden
| | - Danielle Agnello
- School of Health and Life Sciences, Glasgow Caledonian University, UK
| | - Lauren McCaffrey
- School of Health and Life Sciences, Glasgow Caledonian University, UK
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, UK; Department of Movement and Sports Sciences, Ghent University, 9000, Ghent, Belgium
| | - Ragnberth Helleday
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Umeå University, Sweden
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Viegas P, Ageno E, Corsi G, Tagariello F, Razakamanantsoa L, Vilde R, Ribeiro C, Heunks L, Patout M, Fisser C. Highlights from the Respiratory Failure and Mechanical Ventilation 2022 Conference. ERJ Open Res 2023; 9:00467-2022. [PMID: 36949961 PMCID: PMC10026011 DOI: 10.1183/23120541.00467-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022] Open
Abstract
The Respiratory Intensive Care Assembly of the European Respiratory Society gathered in Berlin to organise the second Respiratory Failure and Mechanical Ventilation Conference in June 2022. The conference covered several key points of acute and chronic respiratory failure in adults. During the 3-day conference, ventilatory strategies, patient selection, diagnostic approaches, treatment and health-related quality of life topics were addressed by a panel of international experts. Lectures delivered during the event have been summarised by Early Career Members of the Assembly and take-home messages highlighted.
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Affiliation(s)
- Pedro Viegas
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Elisa Ageno
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant'Orsola-Malpighi, Bologna, Italy
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gabriele Corsi
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant'Orsola-Malpighi, Bologna, Italy
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Federico Tagariello
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, University Hospital Sant'Orsola-Malpighi, Bologna, Italy
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Léa Razakamanantsoa
- Unité Ambulatoire d'Appareillage Respiratoire de Domicile (UAARD), Service de Pneumologie (Département R3S), AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Paris, France
| | - Rudolfs Vilde
- Centre of Pulmonology and Thoracic Surgery, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
- Riga Stradiņš University, Riga, Latvia
| | - Carla Ribeiro
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Leo Heunks
- Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maxime Patout
- Service des Pathologies du Sommeil (Département R3S), AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Christoph Fisser
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
- Corresponding author: Christoph Fisser ()
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Vila M, Rosa Oliveira V, Agustí A. Telemedicine in the management of chronic obstructive pulmonary disease: A systematic review. Med Clin (Barc) 2023; 160:355-363. [PMID: 36801105 DOI: 10.1016/j.medcli.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/18/2023]
Abstract
Telemedicine is defined as the use of electronic technology for information and communication by healthcare professionals with patients (or care givers) aiming at providing and supporting healthcare to patients away from healthcare institutions. This systematic review over the last decade (2013-2022) investigates the use of telemedicine in patients with chronic obstructive pulmonary disease (COPD). We identified 53 publications related to: (1) home tele-monitorization; (2) tele-education and self-management; (3) telerehabilitation; and (4) mobile health (mHealth). Results showed that, although evidence is still weak in many of these domains, results are positive in terms of improvement of health-status, use of health-care resources, feasibility, and patient satisfaction. Importantly, no safety issues were identified. Thus, telemedicine can be considered today as a potential complement to usual healthcare.
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Affiliation(s)
- Marc Vila
- Equipo de Asistencia Primaria Vic , Vic, Barcelona, España; Cátedra Salud Respiratoria, Universidad de Barcelona, Barcelona, España; Equipo de investigación de Metodología, Métodos, Modelos y Resultados de las Ciencias Sociales y de la Salud (M3O), Facultad de Ciencias de la Salud y Bienestar, Universidad de Vic - Universidad Central de Cataluña (UVic-UCC), España.
| | - Vinicius Rosa Oliveira
- Equipo de investigación de Metodología, Métodos, Modelos y Resultados de las Ciencias Sociales y de la Salud (M3O), Facultad de Ciencias de la Salud y Bienestar, Universidad de Vic - Universidad Central de Cataluña (UVic-UCC), España
| | - Alvar Agustí
- Cátedra Salud Respiratoria, Universidad de Barcelona, Barcelona, España; Instituto Respiratorio, Hospital Clínico, Barcelona, España; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, España; CIBER Enfermedades Respiratorias, España
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16
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Chan A, Cohen R, Robinson KM, Bhardwaj D, Gregson G, Jutai JW, Millar J, Ríos Rincón A, Roshan Fekr A. Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review. JMIR Aging 2022; 5:e40079. [PMID: 36441572 PMCID: PMC9745651 DOI: 10.2196/40079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies. OBJECTIVE This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks. METHODS A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented. RESULTS The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied. CONCLUSIONS Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.
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Affiliation(s)
- Andrew Chan
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
- Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Rachel Cohen
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Katherine-Marie Robinson
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada
- Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Devvrat Bhardwaj
- Department of Electrical Engineering and Computer Science, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada
| | - Geoffrey Gregson
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
- Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Jason Millar
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada
- Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Adriana Ríos Rincón
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
- Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Atena Roshan Fekr
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Landete P, Prieto Romo JI, Giacomini F. Experience on the Management of Patients with Asthma or Chronic Obstructive Pulmonary Disease During the COVID-19 Pandemic: the NEUMOBIAL Study. Adv Ther 2022; 39:5216-5228. [PMID: 36114950 PMCID: PMC9483441 DOI: 10.1007/s12325-022-02313-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/01/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) and asthma are treatable but greatly underdiagnosed disorders. Telemedicine made it possible to continue diagnosis, follow-up visits and treatment modifications during the COVID-19 pandemic. The present study describes the management of patients with COPD and asthma, and their treatments during the pandemic from the pulmonologist's perspective. METHODS NEUMOBIAL was an ecological study with aggregated data. A total of 279 Spanish pulmonologists answered a 60-question survey about their last 10 patients, focused on the characterisation and changes in visits and treatments during the pandemic. RESULTS Most pulmonologists (72.0%) considered that the pandemic negatively altered the diagnosis and follow-up of patients with asthma or COPD. Diagnostic tests were reduced during the pandemic, mainly because they were not recommended by pulmonologists (68.1% and 72.7% in the case of COPD and asthma tests, respectively). Moreover, 17.3% of the COPD and 19.1% of the asthma visits were remote visits. According to pulmonologists, low adherence to treatment was mainly due to a lack of patient knowledge about their disease (75.3% and 81.7% in COPD and asthma, respectively). Other factors that also influenced adherence were inadequate use of the inhaler (59.5% for COPD and 57.7% for asthma) and a lack of knowledge about the device (57.3% for COPD and 57.7% for asthma). Pulmonologists chose Zonda® for COPD because of the ease of use of the device (73.1%) and the ability to check whether the entire dose was inhaled (69.5%). For asthma, Spiromax® was chosen because of the ease of use of the device (85.7%) and the possibility of using a single device for maintenance and reliever treatment (82.4%). CONCLUSION According to pulmonologists, during the pandemic, treatments for COPD and asthma were mainly chosen on the basis of their ease of use; treatment adherence was good; and the number of remote visits increased.
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Affiliation(s)
- Pedro Landete
- Servicio de Neumología, Hospital de la Princesa, Madrid, Spain.
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
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Lundell S, Toots A, Sönnerfors P, Halvarsson A, Wadell K. Participatory methods in a digital setting: experiences from the co-creation of an eHealth tool for people with chronic obstructive pulmonary disease. BMC Med Inform Decis Mak 2022; 22:68. [PMID: 35303895 PMCID: PMC8932463 DOI: 10.1186/s12911-022-01806-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/11/2022] [Indexed: 12/22/2022] Open
Abstract
Background Using participatory methods to engage end-users in the development and design of eHealth is important to understand and incorporate their needs and context. Within participatory research, recent social distancing practice has forced a transition to digital communication platforms, a setting that warrants deeper understanding. The aim of this study was to describe the experiences of, and evaluate a digital co-creation process for developing an eHealth tool for people with chronic obstructive pulmonary disease (COPD). Methods The co-creation was guided by Participatory appreciative action and reflection, where a convenience sample (n = 17), including persons with COPD, health care professionals, relatives and a patient organization representative participated in six digital workshops. User instructions, technical equipment, and skilled support were provided if necessary. Workshops centred around different topics, with pre-recorded films, digital lectures and home assignments to up-skill participants. Process validity, experiences and ownership in the co-creation process were evaluated by repeated respondent validation, member checking, questionnaires and by assessing attendance. Data was analysed quantitatively or qualitatively as appropriate. Results The co-creators were in general satisfied with the digital format of the workshops. Mean attendance and perceived engagement in workshops was high and the experience described as enjoyable. Engagement was facilitated by up-skilling activities and discussions in small groups. Few had used digital communication previously, and feelings ranging from excitement to concern were expressed initially. Technical issues, mainly audio related, were resolved with support. At completion, skills using equipment and digital platform surpassed expectations. Few disadvantages with the digital format were identified, and advantages included reduced travel, time efficiency and reduced infection risk. Conclusions Experiences of digital co-creation were overwhelmingly positive, despite initial barriers related to computer naivety and use of digital equipment and platforms. The high level of satisfaction, engagement, attendance rates, and agreement between individual and group views suggests that a digital co-creation process is a feasible method. Several important success factors were identified, such as the provision of information and education on discussion topics in advance of workshops, as well as the smaller group discussions during workshops. The knowledge gained herein will be useful for future digital co-creation processes.
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Affiliation(s)
- Sara Lundell
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden.
| | - Annika Toots
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden
| | - Pernilla Sönnerfors
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Alexandra Halvarsson
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden
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Sculley JA, Musick H, Krishnan JA. Telehealth in chronic obstructive pulmonary disease: before, during, and after the coronavirus disease 2019 pandemic. Curr Opin Pulm Med 2022; 28:93-98. [PMID: 34860202 PMCID: PMC8815630 DOI: 10.1097/mcp.0000000000000851] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Many healthcare systems rapidly implemented telehealth as a substitute for in-person care during the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this review is to describe the evidence base supporting the use of telehealth for chronic obstructive pulmonary disease (COPD) prior to the COVID-19 pandemic, discuss the barriers to implementing telehealth during the pandemic, and share our opinion about the future of telehealth in COPD. RECENT FINDINGS The evidence from randomized clinical trials in COPD completed prior to the COVID-19 pandemic indicate that the effectiveness of telehealth interventions compared to in-person usual care on clinical outcomes is inconclusive. Recent experience during the COVID-19 pandemic indicates that telehealth may increase access to healthcare and satisfaction with care when delivered in addition to usual in-person care. While some reimbursement-related barriers to telehealth have been alleviated during the COVID-19 pandemic, several patient, provider, and health-system barriers to implementation remain. SUMMARY There is a need to further evaluate the delivery of telehealth services as an adjunct to traditional in-person models of COPD care. Standardization and reporting of core clinical, satisfaction, accessibility, and quality of care outcomes are needed to promote cross-study learning and more rapid translation of research evidence into practice.
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The Role of Digital Tools in the Timely Diagnosis and Prevention of Acute Exacerbations of COPD: A Comprehensive Review of the Literature. Diagnostics (Basel) 2022; 12:diagnostics12020269. [PMID: 35204359 PMCID: PMC8870887 DOI: 10.3390/diagnostics12020269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/04/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways and lung parenchyma with multiple systemic manifestations. Exacerbations of COPD are important events during the course of the disease, as they are associated with increased mortality, severe impairment of health-related quality of life, accelerated decline in lung function, significant reduction in physical activity, and substantial economic burden. Telemedicine is the use of communication technologies to transmit medical data over short or long distances and to deliver healthcare services. The need to limit in-person appointments during the COVID-19 pandemic has caused a rapid increase in telemedicine services. In the present review of the literature covering published randomized controlled trials reporting results regarding the use of digital tools in acute exacerbations of COPD, we attempt to clarify the effectiveness of telemedicine for identifying, preventing, and reducing COPD exacerbations and improving other clinically relevant outcomes, while describing in detail the specific telemedicine interventions used.
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21
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Poureslami I, FitzGerald JM, Tregobov N, Goldstein RS, Lougheed MD, Gupta S. Health literacy in asthma and chronic obstructive pulmonary disease (COPD) care: a narrative review and future directions. Respir Res 2022; 23:361. [PMID: 36529734 PMCID: PMC9760543 DOI: 10.1186/s12931-022-02290-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Respiratory self-care places considerable demands on patients with chronic airways disease (AD), as they must obtain, understand and apply information required to follow their complex treatment plans. If clinical and lifestyle information overwhelms patients' HL capacities, it reduces their ability to self-manage. This review outlines important societal, individual, and healthcare system factors that influence disease management and outcomes among patients with asthma and chronic obstructive pulmonary disease (COPD)-the two most common ADs. For this review, we undertook a comprehensive literature search, conducted reference list searches from prior HL-related publications, and added insights from international researchers and scientists with an interest in HL. We identified methodological limitations in currently available HL measurement tools in respiratory care. We also summarized the issues contributing to low HL and system-level cultural incompetency that continue to be under-recognized in AD management and contribute to suboptimal patient outcomes. Given that impaired HL is not commonly recognized as an important factor in AD care, we propose a three-level patient-centered model (strategies) designed to integrate HL considerations, with the goal of enabling health systems to enhance service delivery to meet the needs of all AD patients.
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Affiliation(s)
- Iraj Poureslami
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada ,Canadian Multicultural Health Promotion Society (CMHPS), Vancouver, BC Canada
| | - J. Mark FitzGerald
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada
| | - Noah Tregobov
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, Vancouver-Fraser Medical Program, University of British Columbia, Vancouver, BC Canada
| | - Roger S. Goldstein
- grid.17063.330000 0001 2157 2938Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada ,Respiratory Medicine, Westpark Healthcare Centre, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - M. Diane Lougheed
- grid.410356.50000 0004 1936 8331Asthma Research Unit, Department of Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston, ON Canada ,grid.418647.80000 0000 8849 1617Institute for Clinical Evaluative Sciences, Toronto, ON Canada
| | - Samir Gupta
- grid.415502.7Unity Health, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON Canada
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22
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Thurzo A, Kurilová V, Varga I. Artificial Intelligence in Orthodontic Smart Application for Treatment Coaching and Its Impact on Clinical Performance of Patients Monitored with AI-TeleHealth System. Healthcare (Basel) 2021; 9:healthcare9121695. [PMID: 34946421 PMCID: PMC8701246 DOI: 10.3390/healthcare9121695] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/27/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Treatment of malocclusion with clear removable appliances like Invisalign® or Spark™, require considerable higher level of patient compliance when compared to conventional fixed braces. The clinical outcomes and treatment efficiency strongly depend on the patient's discipline. Smart treatment coaching applications, like strojCHECK® are efficient for improving patient compliance. PURPOSE To evaluate the impact of computerized personalized decision algorithms responding to observed and anticipated patient behavior implemented as an update of an existing clinical orthodontic application (app). MATERIALS AND METHODS Variables such as (1) patient app interaction, (2) patient app discipline and (3) clinical aligner tracking evaluated by artificial intelligence system (AI) system-Dental monitoring® were observed on the set of 86 patients. Two 60-day periods were evaluated; before and after the app was updated with decision tree processes. RESULTS All variables showed significant improvement after the update except for the manifestation of clinical non-tracking in men, evaluated by artificial intelligence from video scans. CONCLUSIONS Implementation of application update including computerized decision processes can significantly enhance clinical performance of existing health care applications and improve patients' compliance. Using the algorithm with decision tree architecture could create a baseline for further machine learning optimization.
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Affiliation(s)
- Andrej Thurzo
- Department of Stomatology and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava, 81250 Bratislava, Slovakia
- Correspondence: ; Tel.: +421-903-110-107
| | - Veronika Kurilová
- Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, 81219 Bratislava, Slovakia;
| | - Ivan Varga
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
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23
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Calvache-Mateo A, López-López L, Heredia-Ciuró A, Martín-Núñez J, Rodríguez-Torres J, Ortiz-Rubio A, Valenza MC. Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312692. [PMID: 34886418 PMCID: PMC8657261 DOI: 10.3390/ijerph182312692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 01/16/2023]
Abstract
Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = −1.26, 95% CI = −1.65, −0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.
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Metting E, Dassen L, Aardoom J, Versluis A, Chavannes N. Effectiveness of Telemonitoring for Respiratory and Systemic Symptoms of Asthma and COPD: A Narrative Review. Life (Basel) 2021; 11:1215. [PMID: 34833091 PMCID: PMC8624095 DOI: 10.3390/life11111215] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/20/2021] [Accepted: 10/28/2021] [Indexed: 12/25/2022] Open
Abstract
Asthma and chronic obstructive pulmonary diseases (COPD) are highly prevalent chronic lung diseases that require ongoing self-management, which itself is often suboptimal. Therefore, telemonitoring has been used to help patients measure their symptoms, share data with healthcare providers and receive education and feedback to improve disease management. In this study, we conducted a narrative review of recent evidence on the effectiveness of telemonitoring for asthma and COPD in adults. Of the thirteen identified studies, eleven focused on COPD and two focused on asthma. All studies were reviewed, and effects were compared between intervention and care as usual groups. Of the study interventions, seven showed a positive outcome on at least one outcome measure, and six had no significant results on any of the outcome measures. All of the interventions with a positive outcome included an educational component, while only one of the six interventions without positive outcomes included an educational component. We conclude that telemonitoring interventions for asthma and COPD seem more effective if they included an educational component regarding different aspects of self-management.
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Affiliation(s)
- Esther Metting
- Data Science Center in Health, University of Groningen, University Medical Center Groningen, 9713 BZ Groningen, The Netherlands
- Department of Operations, Faculty of Economics and Business, University of Groningen, 9724 AV Groningen, The Netherlands;
- National eHealth Living Lab, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands; (J.A.); (A.V.); (N.C.)
| | - Lizayra Dassen
- Department of Operations, Faculty of Economics and Business, University of Groningen, 9724 AV Groningen, The Netherlands;
| | - Jiska Aardoom
- National eHealth Living Lab, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands; (J.A.); (A.V.); (N.C.)
- Public Health and Primary Care, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands
| | - Anke Versluis
- National eHealth Living Lab, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands; (J.A.); (A.V.); (N.C.)
- Public Health and Primary Care, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands
| | - Niels Chavannes
- National eHealth Living Lab, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands; (J.A.); (A.V.); (N.C.)
- Public Health and Primary Care, Medical Center, Leiden University, 2233 ZD Leiden, The Netherlands
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25
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Using Telemedicine to Monitor the Patient with Chronic Respiratory Failure. Life (Basel) 2021; 11:life11111113. [PMID: 34832989 PMCID: PMC8620445 DOI: 10.3390/life11111113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Advances in management have improved mortality of individuals with chronic respiratory failure (CRF), leading to an increase in need for long-term oxygen therapy and/or ventilatory support. These individuals require frequent visits and monitoring of their physiological parameters as well as of the functioning of their devices, such as ventilators or oxygen concentrators. Telemedicine is a clinical application of Information Communication Technology connecting patients to specialised care consultants. This narrative review aims to explore the current available telemonitoring options for individuals with CRF and reported or potential results. Methods: The research focused on EMBASE, CINALH, PubMed, and Scopus databases. Papers published between 2003 and 2021 in English were considered. Results: Different sensors, transmission devices and systems, and interventions are used with promising but not conclusive clinical results. However, legal problems are still unsolved, and economic advantages for health care systems, although potentially high, are still under debate. Conclusions: Telemonitoring systems for individuals with CRF are increasingly used; with promising results still to be clarified, legal, economical and organisational issues must be defined.
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26
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Goyal JP, Kumar P. Telemedicine During the COVID-19 Pandemic: Moving from Physical to Virtual Outpatient Care. Indian J Pediatr 2021; 88:959-960. [PMID: 34449026 PMCID: PMC8393773 DOI: 10.1007/s12098-021-03924-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Jagdish P Goyal
- Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, 342001, India.
| | - Prawin Kumar
- Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, 342001, India
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