Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effectiveness and Cost-effectiveness of Telemedicine for Chronic Obstructive Pulmonary Disease: The Danish "TeleCare North" Pragmatic Cluster-randomized Trial.
Brief Summary: There are two main aims in this study. The first objective is to evaluate whether a particular telehealth solution, in addition to standard treatment and care, lead to a significant decrease in the mortality and an increase in health related quality of life for patients suffering from COPD that may benefit from telehealth compared with only standard treatment and care. The second objective is to examine the additional costs of the telehealth solution and assess whether this solution is a cost-effective way to care for patients with COPD across patients and municipality districts.

It is hypothesized that telehealth care will increase patients quality adjusted life years at both the cluster and individual level compared to usual practice, since no difference in mortality and a higher health related quality of life is expected. Furthermore, it is hoped that there will be a 30% reduction in the number of admissions and readmissions to hospitals and a 30% reduction in the number of outpatient visits resulting in fewer costs for hospitals. However, it is uncertain as to whether these savings are offset by other costs such as more visits to general practitioners, community care or the implementation costs.


Options:
A: Inclusion Criteria:

* diagnosed COPD by spirometry
* in treatment corresponding to GOLD-guidelines
* motivated for treatment of COPD
* COPD is the primary disease
* fixed residence and be affiliated to a general practitioner in North Denmark Region
* At least one of the following criteria should also be met: MRCm (modified) ≥ 2 or MRC ≥3, CAT ≥ 10, have had at least 2 exacerbations within the last 12 months

Exclusion Criteria:

* no phone line or GSM coverage
* unable to understand Danish sufficiently to complete study questionnaires
* have a cognitive impairment
B: Inclusion Criteria:

* Age ≥ 18 years.
* COPD GOLD class 3-4
* Life expectance \> 12 months

Exclusion Criteria:

• Patient unable to use the equipment provided (alone or assisted).
C: Inclusion Criteria:

* Diagnosis of COPD

Exclusion Criteria:

* Diagnosis of other significant lung disease (eg. interstitial lung disease) or dementia
* Lack of WiFi at home
* Inability to speak English
* Inability to use this technology due to physical or cognitive impairment
D: Inclusion Criteria:

* COPD GOLD stage II-IV
* smoking history of \>20 pack years
* adequate pharmacological therapy
* written informed consent

Exclusion Criteria:

* respiratory insufficiency, defined as PaO2\<55 mm Hg and/or PaCO2\>50 mm Hg breathing room air
* manifest cardiac insufficiency
* uncontrolled arterial hypertension
* malignant disease
* symptomatic coronary heart disease resp. pathological cycle ergometry results
* limited physical capabilities caused by musculoskeletal disorders
* unwillingness to return for follow-up
* previous or ongoing participation in exercise training programs
* unability to attend at least 75% of sessions

Answer: A