A qualitative study of COPD-patients’ experience of a telemedicine intervention
Abstract
Background Clinically stable patients with chronic obstructive pulmonary disease (COPD) are often followed at regular intervals regardless of the needs. Our aim was to investigate the patient perspective on receiving telemedicine with weekly submission of readings and regular video consultations (Net-COPD) as an alternative to visits in the respiratory outpatient clinic and investigating the role of telemedicine in management of severe COPD.Design Descriptive design and the method is qualitative based on semistructured interviews.Methods Fourteen intervention patients participated from the Danish randomized clinical trial Net-COPD project. The transcribed interviews were analysed using manifest and latent content analysis.Findings Participants reported that Net-COPD brought enhanced wellbeing and a sense of security in knowing that nurses kept an eye on them and initiated appropriate interventions in case of changes in the patient's condition. This was experienced as a lifeline to the respiratory outpatient clinic, which could be contacted when needed. Through monitoring, moreover, patients developed increased awareness and better self-management of their disease. Patients also experienced more focused and less stressful meetings via video consultations, than in respiratory outpatient visits. Nevertheless it was important that it was the same health staff patient met in the video consultations.Conclusion Participation in telemedicine increased the patient empowerment primarily by the sharing of data with a permanent staff of nurses. This knowledge was used to keep control of the disease in the form of extra readings and the systematic use of learned initiatives. This gave patients and relatives a sense of security.
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The 'improved care' theme was identified in seven of nine included studies.
“The “improved care” theme was identified in seven of nine studies. [19–23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Telemonitoring increased patients' sense of security, with patients feeling more relaxed knowing their health parameters were being monitored.
“Four studies identified an increased sense of security. [20, 22, 25, 26] with patients feeling more relaxed knowing telemonitoring was enabling increased monitoring of their health parameters.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Patients and healthcare professionals reported additional benefits from more individualised treatment plans resulting from telemonitoring interventions.
“Patients and HCPs reported additional benefits in having more individualised treatment plans [19, 21–23, 26] resulting from telemonitoring interventions.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Telemonitoring increased patients' awareness of their health, leading them to make improved lifestyle changes.
“Several patients expressed that telemonitoring increased their awareness of their health and consequently they made improved lifestyle changes. [19, 20, 23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
A nurse in the same study felt telemonitoring led to faster treatment changes, a view shared by participants in another included study.
“However, in direct contrast, a nurse participating in the same study felt the telemonitoring intervention led to faster treatment changes; [23] a view shared by the participants of another included study. [26].”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Communication emerged as a theme in five studies.
““Communication” emerged as a theme in five studies. [21–23, 25, 26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
For some patients, largely COPD patients, the increased sense of security from telemonitoring was considered to improve general health and well-being.
“For some, largely COPD patients, [26] this sense of security was considered to consequentially improve general health and well-being.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Telemonitoring led to increased understanding of disease, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring, and improved oxygen saturation monitoring.
“Three studies [12, 20, 26] mentioned an increased understanding of their disease through telemonitoring, resulting in wider self-care improvements including better insulin adherence, increased blood glucose monitoring [20] and improved oxygen saturation monitoring. [12, 26].”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
Instant feedback and communication back and forth improved patient-professional relationships, with patients able to open up more regarding their health issues.
“The result of “instant feedback” and “communication back and forth” improved patient-professional relationships [21] with patients able to ‘open-up’ more regarding their health issues. [26]”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
While five studies identified clear benefits of telemonitoring, some healthcare professionals highlighted potential drawbacks concerning treatments.
“Whilst five studies [19, 21–23, 26] identified clear benefits of telemonitoring, some HCPs highlighted potential drawbacks concerning treatments.”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
In one study, some individuals felt video consultations were safer and more relaxed than clinics and avoided the travel required to access the clinic in person.
“In this study some individuals felt video consultations were safer and more relaxed than clinics and avoided the travel required to access the clinic in person).”
From Use of telemonitoring in patient self-management of chronic disease: a qualitative meta-synthesis (2023) · cites this paper as [26]
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- Authors
- Nissen, L., & Lindhardt, T.
- Affiliations
- Copenhagen University Hospital (DK)
- Corresponding author
- Nissen, Lene
- ORCID
- Lindhardt, Tove
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 107
- Pages
- 11-17
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W2746728815
- Cited by
- 68
- References
- 21
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 17 · 2022: 11 · 2021: 8 · 2020: 4 · 2019: 8 · 2018: 2
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- chronic obstructive pulmonary disease, telemedicine, patient experience, video consultation, remote patient monitoring, self-management, patient empowerment, nurse-led care, outpatient care
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Self Care, Telemedicine, Pulmonary Disease, Chronic Obstructive, Qualitative Research, Early Medical Intervention
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