A feasibility study to investigate the acceptability and potential effectiveness of a telecare service for older people with chronic obstructive pulmonary disease

Abstract

Aims To investigate the feasibility, acceptance and potential effectiveness of delivering a telecare service on the health outcomes and hospital service utilization of community-dwelling patients with chronic obstructive pulmonary disease.Methods Eligible participants were older people, with moderate or severe chronic obstructive pulmonary disease, and who had been admitted to hospital at least once for exacerbation during the previous year. The participants were randomly assigned to the intervention or control group. Participants in the intervention group received a telecare device kit and they were asked to monitor their oxygen saturation, pulse rate and respiration rate using the device and to transmit the data to an online network platform. A medication and purse-lip breathing reminder with a feedback function is also provided in the device kit. A community nurse monitors changes in the physiological parameters and takes immediate action to address the patients' needs. Participants in the control group received no other extra care. Study outcomes include user satisfaction, health-related quality of life, pulmonary function, hospital re-admission and use of emergency room services.Results Twenty-two participants in the intervention group and 18 in the control group were included in the analysis. The mean age of all 40 participants was 72.93 years. Overall, the participants in the intervention group expressed satisfaction with the telecare service. Some patients reported difficulty in reading the screen of the mobile phone and manipulating the tiny key-in buttons. No significant differences were found between the two time points (baseline and post-test period) with regard to health-related quality of life. No significant differences in pulmonary function and in the number of emergency department visits and hospital re-admissions between the study groups were found.Conclusion The high level of user satisfaction indicated the feasibility of conducting a large-scale randomized control trial to evaluate the effects of a telecare service on health outcomes of patients with chronic obstructive pulmonary disease.