Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: A qualitative study embedded in a randomized controlled trial
Open accessAbstract
Objective To explore patient and professional views on self-management in the context of telemonitoring in chronic obstructive pulmonary disease (COPD).Methods Semi-structured interviews with patients with COPD and healthcare professionals participating in a randomized controlled trial of telemonitoring in Lothian, Scotland, explored experiences of using telemonitoring, and dynamics in patient-practitioner relationships. Transcribed data were analyzed using the Framework approach.Results 38 patients (mean age 67.5 years) and 32 professionals provided 70 interviews. Patients considered that telemonitoring empowered self-management by enhancing their understanding of COPD and providing additional justification for their decisions to adjust treatment or seek professional advice. Professionals discussed telemonitoring as promoting compliance with medical advice and encouraged patients to exercise personal responsibility within clinical parameters, but expressed concerns about promoting the sick role and creating dependence on telemonitoring.Conclusion Telemonitoring assisted many patients to embrace greater responsibility for their health but the model of service provision remained clinician-centered. A medical model of 'compliant self-management' may paradoxically have promoted dependence on professionals.Practice implications Patients and professionals shared responsibility for meeting the central objective of prompt management of exacerbations of COPD. Care is needed, however, to minimize the risk in some patients, of telemonitoring increasing dependence on practitioner support.
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Qualitative explorations of some asthma and COPD interventions suggested that daily professional monitoring of telemonitored parameters (such as pulse oximetry or symptom scores) could engender reliance on professionals rather than supporting self-management.
“However, qualitative explorations of some asthma and COPD interventions suggested that daily professional monitoring of telemonitored parameters (such as pulse oximetry or symptom scores) could engender reliance on professionals rather than supporting self-management [11,76,78,79].”
Qualitative methodologies have highlighted that users valued convenience, a sense of being "watched over", and finding the telemonitoring data reassuring.
“Such questions have been addressed using qualitative methodologies [75], which have highlighted that users valued convenience [76], a sense of being “watched over” [11,77], and finding the telemonitoring data reassuring [78].”
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“…specifically in supporting the management of individual chronic diseases [20]. mHealth apps have been designed and implemented in diabetes [21,22], cardiovascular disease [23], and chronic obstructive pulmonary disease [24] to better engage patients in managing their own health condition.”
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- Authors
- Fairbrother, P., Pinnock, H., Hanley, J., McCloughan, L., Sheikh, A., Pagliari, C., & McKinstry, B.
- Affiliations
- University of Edinburgh (GB)
- Edinburgh Napier University (GB)
- Corresponding author
- Pinnock, Hilary
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 93
- Issue
- 3
- Pages
- 403-410
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W2029535342
- Cited by
- 92
- References
- 36
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 10 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 9 · 2015: 12 · 2014: 5 · 2013: 5
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Research Output (Edinburgh Napier University) (submittedVersion)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- remote patient monitoring, self-management, chronic obstructive pulmonary disease, patient-practitioner relationship, patient empowerment, medication adherence, sick role, COPD exacerbation treatment
- MeSH terms
- Aged, Attitude of Health Personnel, Continuity of Patient Care, Counseling, Female, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Compliance, Primary Health Care, Quality of Life, Scotland, Self Care, Program Evaluation, Telemedicine, Disease Management, Pulmonary Disease, Chronic Obstructive, Qualitative Research
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