Piloting tele-monitoring in COPD: a mixed methods exploration of issues in design and implementation
Open accessAbstract
Background In 2008 NHS Lothian implemented a COPD tele-monitoring service incorporating a touch-screen computer for daily recording of symptoms and weekly oximetry and spirometry measurement. Data were transmitted by secure broadband link to a call centre where trained workers monitored data and contacted clinicians according to an agreed algorithm.Aims To explore the perceptions of patients and professionals about the pilot implementation of the COPD tele-monitoring service.Methods In-depth interviews were undertaken with patients and professionals before and after installation of the tele-monitoring equipment. Interviews were recorded, transcribed and thematically analysed. Data on use of healthcare resources were obtained from primary care records.Results Twenty of the 27 patients in the pilot and 25 professionals participated. (n=55 interviews and one focus group). Patients were generally positive about the technology, which they perceived enabled earlier recognition of exacerbations and facilitated access to clinical advice. In contrast, clinicians had concerns about false positive symptom scores, difficulties in interpreting physiological data, overtreatment (reflected in a large increase in antibiotics and steroid prescribing), and an increased workload.Conclusions Tele-monitoring was perceived by patients as improving access to professional care, but raised concerns for clinicians about possible over-treatment and how best to organise services to support the technology.
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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].”
Some felt empowered by these interventions to use the health care system more effectively.
“Some felt empowered by these interventions to use the health care system more effectively [76,77].”
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- Authors
- Ure, J., Pinnock, H., Hanley, J., Kidd, G., Smith, E. M., Tarling, A., Pagliari, C., Sheikh, A., MacNee, W., & McKinstry, B.
- Affiliations
- Edinburgh Napier University (GB)
- University of Edinburgh (GB)
- Edinburgh Royal Infirmary (GB)
- Centre for Inflammation Research (GB)
- Corresponding author
- Pinnock, Hilary
- Venue
- Primary Care Respiratory Journal
- Published
- 2011-07-22
- Volume
- 21
- Issue
- 1
- Pages
- 57-64
- ISSN
- 1471-4418 (ISSN-L)
- 1475-1534
- PMC
- PMC6548305
- OpenAlex
- W2086546412
- Cited by
- 106
- References
- 21
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 12 · 2021: 7 · 2020: 5 · 2019: 8 · 2018: 4 · 2017: 12 · 2016: 9 · 2015: 13 · 2014: 12 · 2013: 9 · 2012: 3
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Primary Care Respiratory Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (publishedVersion)
- Funders
- Wellcome Trust
- Scottish Government
- 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, remote patient monitoring, oximetry, spirometry, patient perspectives, clinician perceptions, overtreatment, antibiotic prescribing, clinician workload, service implementation, NHS Lothian
- MeSH terms
- Aged, Attitude of Health Personnel, Computers, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Oximetry, Primary Health Care, Surveys and Questionnaires, Spirometry, Focus Groups, Telemedicine, Pulmonary Disease, Chronic Obstructive
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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