Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .
Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial
Objective To assess the effect of second generation , home based telehealth on health related quality of life , anxiety , and depressive symptoms over 12 months in patients with long term conditions . Design A study of patient reported outcomes ( the Whole Systems Demonstrator telehealth question naire study ; baseline n=1573 ) was nested in a pragmatic , cluster r and omised trial of telehealth ( the Whole Systems Demonstrator telehealth trial , n=3230 ) . General practice was the unit of r and omisation , and telehealth was compared with usual care . Data were collected at baseline , four months ( short term ) , and 12 months ( long term ) . Primary intention to treat analyses tested treatment effectiveness ; multilevel models controlled for clustering by general practice and a range of covariates . Analyses were conducted for 759 participants who completed question naire measures at all three time points ( complete case cohort ) and 1201 who completed the baseline assessment plus at least one other assessment ( available case cohort ) . Secondary per protocol analyses tested treatment efficacy and included 633 and 1108 participants in the complete case and available case cohorts , respectively . Setting Provision of primary and secondary care via general practice s , specialist nurses , and hospital clinics in three diverse regions of Engl and ( Cornwall , Kent , and Newham ) , with established integrated health and social care systems . Participants Patients with chronic obstructive pulmonary disease ( COPD ) , diabetes , or heart failure recruited between May 2008 and December 2009 . Main outcome measures Generic , health related quality of life ( assessed by physical and mental health component scores of the SF-12 , and the EQ-5D ) , anxiety ( assessed by the six item Brief State-Trait Anxiety Inventory ) , and depressive symptoms ( assessed by the 10 item Centre for Epidemiological Studies Depression Scale ) . Results In the intention to treat analyses , differences between treatment groups were small and non-significant for all outcomes in the complete case ( 0.480≤P≤0.904 ) or available case ( 0.181≤P≤0.905 ) cohorts . The magnitude of differences between trial arms did not reach the trial defined , minimal clinical ly important difference ( 0.3 st and ardised mean difference ) for any outcome in either cohort at four or 12 months . Per protocol analyses replicated the primary analyses ; the main effect of trial arm ( telehealth v usual care ) was non-significant for any outcome ( complete case cohort 0.273≤P≤0.761 ; available case cohort 0.145≤P≤0.696 ) . Conclusions Second generation , home based telehealth as implemented in the Whole Systems Demonstrator Evaluation was not effective or efficacious compared with usual care only . Telehealth did not improve quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease , diabetes , or heart failure over 12 months . The findings suggest that concerns about potentially deleterious effect of telehealth are unfounded for most patients . Trial Registration IS RCT N43002091
Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .