Home telemonitoring effectiveness in COPD: a systematic review.
Open accessAbstract
OBJECTIVES: To provide a systematic review of the effectiveness of home telemonitoring to reduce healthcare utilisation and improve health-related outcomes of patients with chronic obstructive pulmonary disease (COPD). METHODS: An electronic literature search in Medline, Embase, B-on and Web of Science was conducted from June to August 2012 and updated until July 2013, using the following keywords: [tele(-)monitoring or tele(-)health or tele(-)homecare or tele(-)care or tele-home health or home monitoring] and [Chronic Obstructive Pulmonary Disease or COPD]. Randomised and non-randomised controlled trials evaluating home telemonitoring interventions in COPD were included. A meta-analysis using risk ratio (RR) and standardised mean difference (SMD) was conducted for healthcare utilisation (hospitalisations, length of stay, emergency department visits) and associated costs, and health-related outcomes [mortality, exacerbations and health-related quality of life (HRQOL)]. RESULTS: Nine articles were included. Significant differences were found for hospitalisation rates (RR = 0.72; 95% CI = 0.53-0.98; p = 0.034); however, no differences in the other healthcare utilisation outcomes were observed. There was a trend to reduced healthcare costs in the telemonitoring group. In two studies, this intervention was associated with a reduced number of exacerbations (p < 0.05) and a significant increase in HRQOL (SMD = -0.53; 95% CI = -0.97- -0.09; p = 0.019). DISCUSSION AND CONCLUSIONS: Home telemonitoring appears to have a positive effect in reducing respiratory exacerbations and hospitalisations and improving quality of life. However, the evidence of its benefits is still limited and further research is needed to assess the effectiveness of home telemonitoring in COPD management, as there are still few studies in this area.
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Limited evidence was found of the effect of home based remote monitoring to reduce health care utilization, quality of life and respiratory exacerbations in COPD patients.
“while the fourth found limited evidence of the effect of home based remote monitoring to reduce health care utilization, quality of life and respiratory exacerbations in COPD patients [57].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [57]
The Abstract and Discussion describe limited evidence that home telemonitoring reduces respiratory exacerbations and some healthcare use in COPD; the Discussion says there is no clear indication of reduced healthcare use overall. The claim’s wording also suggests a reduction in quality of life, whereas both passages report an improvement in health-related quality of life. Page numbers were not provided in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredFour reviews (3 meta-analyses and 1 narrative synthesis) analyzed the impact of telehealth on all-cause mortality, and none showed a significant difference versus usual care.
“A total of 4 reviews (3 meta-analyses and 1 narrative syntheses) analyzed the impact of telehealth on all-cause mortality, and none showed a significant difference versus usual care [65,66,68,69,71,72].”
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].”
Four 1-star weighted narrative syntheses emphasized either a lack or a low quality of evidence for improved health outcomes in COPD.
“Four 1-star weighted narrative syntheses emphasized either a lack [27,64,65] or a low quality [66] of evidence for improved health outcomes.”
None of the reviews assessing mortality in COPD showed any significant improvement with telehealth.
“In contrast, none of the reviews assessing mortality in COPD showed any significant improvement with telehealth [65,66,68,69].”
Findings for monitoring and feedback in asthma and COPD were mostly neutral or inconsistent.
“This was the most commonly described telehealth component in the included systematic reviews and was associated with improved clinical outcomes in diabetes and heart failure [33,35,36,38,42,44,54,58]; however, findings for asthma and COPD were mostly neutral or inconsistent [61-63,65,66,68,69].”
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- Authors
- Cruz, J., Brooks, D., & Marques, A.
- Affiliations
- University of Aveiro (PT)
- University of Toronto (CA)
- Universidade do Porto (PT)
- Corresponding author
- Marques, A.
- Venue
- International Journal of Clinical Practice
- Publisher
- Hindawi Limited
- Published
- 2014-01-28
- Volume
- 68
- Issue
- 3
- Pages
- 369-378
- ISSN
- 1368-5031 (ISSN-L)
- OpenAlex
- W1985303908
- Semantic Scholar
- afcaf9ab9545862f6cb0b186bc4218a29a2c4d7c
- Cited by
- 147
- References
- 34
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 13 · 2022: 14 · 2021: 12 · 2020: 22 · 2019: 18 · 2018: 8 · 2017: 19 · 2016: 15 · 2015: 5 · 2014: 3
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Funders
- Funda��o para a Ci�ncia e Tecnologia (SFRH/BD/81328/2011)
- 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
- home health monitoring, chronic obstructive pulmonary disease, health care utilization, hospitalization, health care costs, respiratory exacerbations, health-related quality of life, telemedicine, COPD management
- MeSH terms
- Emergency Service, Hospital, Home Care Services, Hospitalization, Humans, Patient Acceptance of Health Care, Quality of Life, Recurrence, Treatment Outcome, Health Care Costs, Telemedicine, Monitoring, Ambulatory, Pulmonary Disease, Chronic Obstructive
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