Telehealthcare in COPD: a systematic review and meta-analysis on physical outcomes and dyspnea.
Open accessAbstract
BACKGROUND Only a minority of patients with chronic obstructive pulmonary disease (COPD) have access to pulmonary rehabilitation (PR). Home-based solutions such as telehealthcare, have been used in efforts to make PR more available. The aim of this systematic review was to investigate the effects of telehealthcare on physical activity level, physical capacity and dyspnea in patients with COPD, and to describe the interventions used. METHODS Randomized controlled trials were identified through database searches, reference lists and included authors. Articles were reviewed based on eligibility criteria by three authors. Risk of bias was assessed by two authors. Standardized mean differences (SMD) or mean differences (MD) with 95% CI were calculated. Forest plots were used to present data visually. RESULTS Nine studies (982 patients) were included. For physical activity level, there was a significant effect favoring telehealthcare (MD, 64.7 min; 95% CI, 54.4-74.9). No difference between groups was found for physical capacity (MD, -1.3 m; 95% CI, -8.1-5.5) and dyspnea (SMD, 0.088; 95% CI, -0.056-0.233). Telehealthcare was promoted through phone calls, websites or mobile phones, often combined with education and/or exercise training. Comparators were ordinary care, exercise training and/or education. CONCLUSIONS The use of telehealthcare may lead to improvements in physical activity level, although the results should be interpreted with caution given the heterogeneity in studies. This is an important area of research and further studies of the effect of telehealthcare for patients with COPD would be beneficial. REGISTRATION In PROSPERO 2012: CRD42012003294. STUDY PROTOCOL http://www.crd.york.ac.uk/PROSPEROFILES/3294_PROTOCOL_20121016.pdf.
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For patients with COPD, limited evidence suggested that remote monitoring with telephone support could lead to improvements in physical activity.
“For patients with chronic obstructive pulmonary disease (COPD), limited evidence suggested that remote monitoring with and telephone support could lead to improvements in physical activity [32].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [32]
The Conclusion says telehealthcare may increase physical activity in patients with COPD and cautions that the evidence is heterogeneous. The Telehealthcare interventions section describes both remote reporting and telephone support, but the Physical activity level section says the final meta-analysis drew on only two groups from one study; it does not establish an improvement specifically from remote monitoring combined with telephone support. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe COPD reviews included 2 meta-analyses, both weighted 2 stars.
“These included 2 meta-analyses, both weighted 2 stars [67,68].”
Both 2-star COPD meta-analyses concerned home-based telehealth using a variety of technologies, incorporating information transmission with personalized feedback.
“Both 2-star meta-analyses concerned home-based telehealth using a variety of technologies, incorporating information transmission with personalized feedback.”
Of the 8 COPD reviews, 7 analyzed the impact on disease control.
“Of the 8 COPD reviews, 7 analyzed the impact on disease control [27,64-69].”
Lundell et al showed a significant improvement in physical activity with telehealth, but no impact on dyspnea.
“Lundell et al showed a significant improvement in physical activity with telehealth, but no impact on dyspnea [67].”
In asthma and COPD, findings for remote clinical review were typically neutral.
“In asthma and COPD, the findings were typically neutral [27,67].”
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- Authors
- Lundell, S., Holmner, Å., Rehn, B., Nyberg, A., & Wadell, K.
- Affiliations
- Umeå University (SE)
- Corresponding author
- Lundell, Sara
- Venue
- Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 109
- Issue
- 1
- Pages
- 11-26
- ISSN
- 0954-6111 (ISSN-L)
- OpenAlex
- W2074815806
- Semantic Scholar
- eab16c5c1c024b8d3b72b6165cae6ab321e4b676
- Cited by
- 203
- References
- 51
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 16 · 2022: 29 · 2021: 32 · 2020: 21 · 2019: 12 · 2018: 22 · 2017: 21 · 2016: 20 · 2015: 6
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Respiratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Riksförbundet HjärtLung
- Vetenskapsrådet
- 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
- telemedicine, chronic obstructive pulmonary disease, pulmonary rehabilitation, home-based rehabilitation, physical activity, physical capacity, dyspnea, exercise training, patient education, telephone-delivered intervention, mobile health
- MeSH terms
- Telerehabilitation, Dyspnea, Humans, Motor Activity, Treatment Outcome, Pulmonary Disease, Chronic Obstructive
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