Subgroup analysis showed that telemonitoring reduced exacerbation rates when the intervention continued for longer than six months or pulmonary function was monitored .
Conclusions Telemonitoring for chronic obstructive pulmonary disease was unlikely to result in statistically significant improvements in health outcomes .
However , our novel finding was that at least six months of intervention duration and monitoring of pulmonary function play roles in activating the effects of telemonitoring
Aims The purpose of this research was to investigate the effectiveness of telemonitoring for chronic obstructive pulmonary disease .
A pilot randomised controlled trial of a Telehealth intervention in patients with chronic obstructive pulmonary disease: challenges of clinician-led data collection
Background 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 pilot r and omised controlled trial ( RCT ) of Telehealth-supported care within a community-based COPD supported-discharge service . Methods A two-arm pragmatic pilot RCT was conducted comparing the st and ard service with a Telehealth-supported service and assessed the potential for progressing into a full RCT . The co- primary outcome measures were the proportion of COPD patients readmitted to hospital and changes in patients ’ self-reported quality of life . The objectives were to assess the suitability of the methodology , produce a sample size calculation for a full RCT , and to give an indication of cost-effectiveness for both pathways . Results Sixty three participants were recruited ( n = 31 St and ard ; n = 32 Telehealth ) ; 15 participants were excluded from analysis due to inadequate data completion or withdrawal from the Telehealth arm . Recruitment was slow with significant gaps in data collection , due predominantly to an unanticipated 60 % reduction of staff capacity within the clinical team . The sample size calculation was guided by estimates of clinical ly important effects and COPD readmission rates derived from the literature . Descriptive analyses showed that the st and ard service group had a lower proportion of patients with hospital readmissions and a greater increase in self-reported quality of life compared to the Telehealth-supported group . Telehealth was cost-effective only if hospital admissions data were excluded . Conclusions Slow recruitment rates and service reconfigurations prevented progression to a full RCT . Although there are advantages to conducting an RCT with data collection conducted by a frontline clinical team , in this case , challenges arose when re sources within the team were reduced by external events . Gaps in data collection were resolved by recruiting a research nurse . This study reinforces previous findings regarding the difficulty of undertaking evaluation of complex interventions , and provides recommendations for the introduction and evaluation of complex interventions within clinical setting s , such as prioritisation of research within the clinical remit . Trial registration Current Controlled Trials IS RCT N68856013 , registered Nov 2010
Subgroup analysis showed that telemonitoring reduced exacerbation rates when the intervention continued for longer than six months or pulmonary function was monitored .
Conclusions Telemonitoring for chronic obstructive pulmonary disease was unlikely to result in statistically significant improvements in health outcomes .
However , our novel finding was that at least six months of intervention duration and monitoring of pulmonary function play roles in activating the effects of telemonitoring
Aims The purpose of this research was to investigate the effectiveness of telemonitoring for chronic obstructive pulmonary disease .