A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations
Abstract
:1. Introduction
2. Methods
2.1. Protocol and Registration
2.2. Eligibility Criteria
2.3. Search Strategy and Data Sources
2.4. Data Extraction
2.5. Risk of Bias Assessment
2.6. Study Outcomes, Analytic Approach, and Statistical Analysis
3. Results
3.1. Study Selection
3.2. Risk of Bias Assessment
3.3. Systematic Review: Broad Overview and Study Characteristics of All Included Studies
3.3.1. Study Characteristics
3.3.2. Telemonitoring Intervention
3.3.3. Telemonitoring Effects
3.4. Meta-Analysis: Telemonitoring Effects on Reducing Severe COPD Exacerbations
3.4.1. Admissions Due to COPD Exacerbations
3.4.2. ER Visits Due to COPD Exacerbations
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available online: https://goldcopd.org/ (accessed on 21 December 2020).
- Murphy, L.A.; Harrington, P.; Taylor, S.J.; Teljeur, C.; Smith, S.M.; Pinnock, H.; Ryan, M. Clinical-effectiveness of self-management interventions in chronic obstructive pulmonary disease: An overview of reviews. Chronic Respir. Dis. 2017, 14, 276–288. [Google Scholar] [CrossRef]
- Almojaibel, A.A. Delivering pulmonary rehabilitation for patients with chronic obstructive pulmonary disease at home using telehealth: A review of the literature. Saudi J. Med. Sci. 2016, 4, 164–171. [Google Scholar] [CrossRef]
- Gregersen, T.L.; Green, A.; Frausing, E.; Ringbaek, T.; Brondum, E.; Suppli Ulrik, C. Do telemedical interventions improve quality of life in patients with COPD? A systematic review. Int. J. Chronic Obstr. Pulm. Dis. 2016, 11, 809–822. [Google Scholar]
- McLean, S.; Nurmatov, U.; Liu, J.L.; Pagliari, C.; Car, J.; Sheikh, A. Telehealthcare for chronic obstructive pulmonary disease: Cochrane review and meta-analysis. Br. J. Gen. Pract. 2012, 62, e739–e749. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Udsen, F.W.; Hejlesen, O.; Ehlers, L.H. A systematic review of the cost and cost-effectiveness of telehealth for patients suffering from chronic obstructive pulmonary disease. J. Telemed. Telecare 2014, 20, 212–220. [Google Scholar] [CrossRef] [PubMed]
- Lundell, S.; Holmner, A.; Rehn, B.; Nyberg, A.; Wadell, K. Telehealthcare in COPD: A systematic review and meta-analysis on physical outcomes and dyspnea. Respir. Med. 2015, 109, 11–26. [Google Scholar] [CrossRef] [Green Version]
- Polisena, J.; Coyle, D.; Coyle, K.; McGill, S. Home telehealth for chronic disease management: A systematic review and an analysis of economic evaluations. Int. J. Technol. Assess. Health Care 2009, 25, 339–349. [Google Scholar] [CrossRef]
- Kruse, C.; Pesek, B.; Anderson, M.; Brennan, K.; Comfort, H. Telemonitoring to manage chronic obstructive pulmonary disease: Systematic literature review. JMIR Med. Inform. 2019, 7, e11496. [Google Scholar] [CrossRef]
- Bolton, C.E.; Waters, C.S.; Peirce, S.; Elwyn, G.; Epsrc; Team MRCGC. Insufficient evidence of benefit: A systematic review of home telemonitoring for COPD. J. Eval. Clin. Pract. 2011, 17, 1216–1222. [Google Scholar] [CrossRef]
- Cruz, J.; Brooks, D.; Marques, A. Home telemonitoring effectiveness in COPD: A systematic review. Int. J. Clin. Pract. 2014, 68, 369–378. [Google Scholar] [CrossRef]
- Kamei, T.; Yamamoto, Y.; Kajii, F.; Nakayama, Y.; Kawakami, C. Systematic review and meta-analysis of studies involving telehome monitoring-based telenursing for patients with chronic obstructive pulmonary disease. Jpn. J. Nurs. Sci. 2013, 10, 180–192. [Google Scholar] [CrossRef] [Green Version]
- Alwashmi, M.; Hawboldt, J.; Davis, E.; Marra, C.; Gamble, J.M.; Abu Ashour, W. The effect of smartphone interventions on patients with chronic obstructive pulmonary disease exacerbations: A systematic review and meta-analysis. JMIR mHealth uHealth 2016, 4, e105. [Google Scholar] [CrossRef]
- Sul, A.R.; Lyu, D.H.; Park, D.A. Effectiveness of telemonitoring versus usual care for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J. Telemed. Telecare 2020, 26, 189–199. [Google Scholar] [CrossRef]
- Global Health Observatory (GHO) Data. Available online: https://www.who.int/gho/goe/telehealth/en/#:~:text=Telehealth%20is%20the%20%22delivery%20of,continuing%20education%20of%20health%20professionals (accessed on 8 February 2020).
- Bashshur, R.L.; Shannon, G.W.; Smith, B.R.; Alverson, D.C.; Antoniotti, N.; Barsan, W.G.; Bashshur, N.; Brown, E.M.; Coye, M.J.; Doarn, C.R.; et al. The empirical foundations of telemedicine interventions for chronic disease management. Telemed. J. E Health 2014, 20, 769–800. [Google Scholar] [CrossRef] [Green Version]
- Alrajeh, A.M.; Aldabayan, Y.S.; Aldhair, A.M.; Pickett, E.; Quaderi, S.A.; Alqahtani, J.S.; Lipman, M.; Hurst, J.R. Global use, utility, and methods of tele-health in COPD: A health care provider survey. Int. J. Chronic Obstr. Pulm. Dis. 2019, 14, 1713–1719. [Google Scholar] [CrossRef] [Green Version]
- Lewis, K.E.; Annandale, J.A.; Warm, D.L.; Rees, S.E.; Hurlin, C.; Blyth, H.; Syed, Y.; Lewis, L. Does home telemonitoring after pulmonary rehabilitation reduce healthcare use in optimized COPD? A pilot randomized trial. COPD J. Chronic Obstr. Pulm. Dis. 2010, 7, 44–50. [Google Scholar] [CrossRef]
- De San Miguel, K.; Smith, J.; Lewin, G. Telehealth remote monitoring for community-dwelling older adults with chronic obstructive pulmonary disease. Telemed. e-Health 2013, 19, 652–657. [Google Scholar] [CrossRef]
- Higgins, J.; Thomas, J.; Chandler, J.; Cumpston, M.; Li, T.; Page, M.J.; Welch, V.A. Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (Updated September 2020). Available online: www.trainingcochrane.org/handbook (accessed on 8 February 2020).
- Huedo-Medina, T.B.; Sanchez-Meca, J.; Marin-Martinez, F.; Botella, J. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol. Methods 2006, 11, 193–206. [Google Scholar] [CrossRef] [Green Version]
- Egger, M.; Davey Smith, G.; Schneider, M.; Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997, 315, 629–634. [Google Scholar] [CrossRef] [Green Version]
- de Toledo, P.; Jimenez, S.; del Pozo, F.; Roca, J.; Alonso, A.; Hernandez, C. Telemedicine experience for chronic care in COPD. IEEE Trans. Inf. Technol. Biomed. 2006, 10, 567–573. [Google Scholar] [CrossRef] [Green Version]
- Koff, P.B.; Jones, R.H.; Cashman, J.M.; Voelkel, N.F.; Vandivier, R.W. Proactive integrated care improves quality of life in patients with COPD. Eur. Respir. J. 2009, 33, 1031–1038. [Google Scholar] [CrossRef] [Green Version]
- Shany, T.; Hession, M.; Pryce, D.; Galang, R.; Roberts, M.; Lovell, N.; Basilakis, J. Home telecare study for patients with chronic lung disease in the Sydney West Area Health Service. Stud. Health Technol. Inform. 2010, 161, 139–148. [Google Scholar] [PubMed]
- Antoniades, N.C.; Rochford, P.D.; Pretto, J.J.; Pierce, R.J.; Gogler, J.; Steinkrug, J.; Sharpe, K.; McDonald, C.F. Pilot study of remote telemonitoring in COPD. Telemed. e-Health 2012, 18, 634–640. [Google Scholar] [CrossRef] [PubMed]
- Chau, J.P.; Lee, D.T.; Yu, D.S.; Chow, A.Y.; Yu, W.C.; Chair, S.Y.; Lai, A.S.F.; Chick, Y.-L. A feasibility study to investigate the acceptability and potential effectiveness of a telecare service for older people with chronic obstructive pulmonary disease. Int. J. Med. Inform. 2012, 81, 674–682. [Google Scholar] [CrossRef]
- Dinesen, B.; Haesum, L.K.; Soerensen, N.; Nielsen, C.; Grann, O.; Hejlesen, O.; Toft, E.; Ehlers, L. Using preventive home monitoring to reduce hospital admission rates and reduce costs: A case study of telehealth among chronic obstructive pulmonary disease patients. J. Telemed. Telecare 2012, 18, 221–225. [Google Scholar] [CrossRef]
- Pinnock, H.; Hanley, J.; McCloughan, L.; Todd, A.; Krishan, A.; Lewis, S.; Stoddart, A.; van der Pol, M.; MacNee, W.; Sheikh, A.; et al. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: Researcher blind, multicentre, randomised controlled trial. BMJ 2013, 347, f6070. [Google Scholar] [CrossRef] [Green Version]
- Pedone, C.; Chiurco, D.; Scarlata, S.; Incalzi, R.A. Efficacy of multiparametric telemonitoring on respiratory outcomes in elderly people with COPD: A randomized controlled trial. BMC Health Serv. Res. 2013, 13, 82. [Google Scholar] [CrossRef] [Green Version]
- Sorknaes, A.D.; Bech, M.; Madsen, H.; Titlestad, I.L.; Hounsgaard, L.; Hansen-Nord, M.; Jest, P.; Olesen, F.; Lauridsen, J.; Østergaard, B. The effect of real-time teleconsultations between hospital-based nurses and patients with severe COPD discharged after an exacerbation. J. Telemed. Telecare 2013, 19, 466–474. [Google Scholar] [CrossRef]
- Bentley, C.L.; Mountain, G.A.; Thompson, J.; Fitzsimmons, D.A.; Lowrie, K.; Parker, S.G.; Hawley, M.S. A pilot randomised controlled trial of a Telehealth intervention in patients with chronic obstructive pulmonary disease: Challenges of clinician-led data collection. Trials 2014, 15, 313. [Google Scholar] [CrossRef] [Green Version]
- Segrelles Calvo, G.; Gomez-Suarez, C.; Soriano, J.B.; Zamora, E.; Gonzalez-Gamarra, A.; Gonzalez-Bejar, M.; Jordán, A.; Tadeo, E.; Sebastián, A.; Fernández, G.; et al. A home telehealth program for patients with severe COPD: The PROMETE study. Respir. Med. 2014, 108, 453–462. [Google Scholar] [CrossRef] [Green Version]
- McDowell, J.E.; McClean, S.; FitzGibbon, F.; Tate, S. A randomised clinical trial of the effectiveness of home-based health care with telemonitoring in patients with COPD. J. Telemed. Telecare 2015, 21, 80–87. [Google Scholar] [CrossRef] [PubMed]
- Ringbaek, T.; Green, A.; Laursen, L.C.; Frausing, E.; Brondum, E.; Ulrik, C.S. Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease: A randomized clinical trial. Int. J. Chronic Obstr. Pulm. Dis. 2015, 10, 1801–1808. [Google Scholar]
- Cordova, F.C.; Ciccolella, D.; Grabianowski, C.; Gaughan, J.; Brennan, K.; Goldstein, F.; Jacobs, M.R.; Criner, G.J. A telemedicine-based intervention reduces the frequency and severity of COPD exacerbation symptoms: A randomized, controlled trial. Telemed. e-Health 2016, 22, 114–122. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ho, T.W.; Huang, C.T.; Chiu, H.C.; Ruan, S.Y.; Tsai, Y.J.; Yu, C.J.; Lai, F. Effectiveness of telemonitoring in patients with chronic obstructive pulmonary disease in Taiwan—A randomized controlled trial. Sci. Rep. 2016, 6, 23797. [Google Scholar]
- Vianello, A.; Fusello, M.; Gubian, L.; Rinaldo, C.; Dario, C.; Concas, A.; Saccavini, C.; Battistella, L.; Pellizzon, G.; Zanardi, G.; et al. Home telemonitoring for patients with acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial. BMC Pulm. Med. 2016, 16, 157. [Google Scholar] [CrossRef] [Green Version]
- Farmer, A.; Williams, V.; Velardo, C.; Shah, S.A.; Yu, L.M.; Rutter, H.; Jones, L.; Williams, N.; Heneghan, C.; Price, J.; et al. Self-management support using a digital health system compared with usual care for chronic obstructive pulmonary disease: Randomized controlled trial. J. Med. Internet Res. 2017, 19, e144. [Google Scholar] [CrossRef] [Green Version]
- Walker, P.P.; Pompilio, P.P.; Zanaboni, P.; Bergmo, T.S.; Prikk, K.; Malinovschi, A.; Montserrat, J.M.; Middlemass, J.; Šonc, S.; Munaro, G.; et al. Telemonitoring in chronic obstructive pulmonary disease (CHROMED). A randomized clinical trial. Am. J. Respir. Crit. Care Med. 2018, 198, 620–628. [Google Scholar] [CrossRef]
- Boer, L.; Bischoff, E.; van der Heijden, M.; Lucas, P.; Akkermans, R.; Vercoulen, J.; Heijdra, Y.; Assendelft, W.; Schermer, T. A smart mobile health tool versus a paper action plan to support self-management of chronic obstructive pulmonary disease exacerbations: Randomized controlled trial. JMIR mHealth uHealth 2019, 7, e14408. [Google Scholar] [CrossRef]
- Paré, G.; Poba-Nzaou, P.; Sicotte, C.; Beaupré, A.; Lefrançois, É.; Nault, D.; Saint-Jules, D. Comparing the costs of home telemonitoring and usual care of chronic obstructive pulmonary disease patients: A randomized controlled trial. Eur. Res. Telemed. 2013, 2, 35–47. [Google Scholar] [CrossRef]
- Jakobsen, A.S.; Laursen, L.C.; Rydahl-Hansen, S.; Østergaard, B.; Gerds, T.A.; Emme, C.; Schou, L.; Phanareth, K. Home-based telehealth hospitalization for exacerbation of chronic obstructive pulmonary disease: Findings from “the virtual hospital” trial. Telemed. e-Health 2015, 21, 364–373. [Google Scholar] [CrossRef] [Green Version]
- Schou, L.; Østergaard, B.; Rydahl-Hansen, S.; Rasmussen, L.S.; Emme, C.; Jakobsen, A.S.; Phanareth, K. A randomised trial of telemedicine-based treatment versus conventional hospitalisation in patients with severe COPD and exacerbation—effect on self-reported outcome. J. Telemed. Telecare 2013, 19, 160–165. [Google Scholar] [CrossRef]
- Vasilopoulou, M.; Papaioannou, A.I.; Kaltsakas, G.; Louvaris, Z.; Chynkiamis, N.; Spetsioti, S.; Kortianou, E.; Genimata, S.A.; Palamidas, A.; Kostikas, K.; et al. Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits. Eur. Respir. J. 2017, 49. [Google Scholar] [CrossRef]
- Hansen, H.; Bieler, T.; Beyer, N.; Kallemose, T.; Wilcke, J.T.; Østergaard, L.M.; Andeassen, H.F.; Martinez, G.; Lavesen, M.; Frølich, A.; et al. Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: A randomised multicentre trial. Thorax 2020, 75, 413–421. [Google Scholar] [CrossRef] [Green Version]
- Al Rajeh, A.; Steiner, M.C.; Aldabayan, Y.; Aldhahir, A.; Pickett, E.; Quaderi, S.; Hurst, J.R. Use, utility and methods of telehealth for patients with COPD in England and Wales: A healthcare provider survey. BMJ Open Respir. Res. 2019, 6, e000345. [Google Scholar] [CrossRef] [Green Version]
- Pedone, C.; Lelli, D. Systematic review of telemonitoring in COPD: An update. Adv. Respir. Med. 2015, 83, 476–484. [Google Scholar] [CrossRef] [Green Version]
- Ancochea, J.; Garcia-Rio, F.; Vazquez-Espinosa, E.; Hernando-Sanz, A.; Lopez-Yepes, L.; Galera-Martinez, R.; Peces-Barba, G.; Pérez-Warnisher, M.T.; Segrelles-Calvo, G.; Zamarro, C.; et al. Efficacy and costs of telehealth for the management of COPD: The PROMETE II trial. Eur. Respir. J. 2018, 51. [Google Scholar] [CrossRef] [Green Version]
1st Author (Publication Year) | Study Duration (Month) | No. of Participants | Male (%) | Mean Age (Years) | Mean FEV1 (Litre or % of Predicted) | Study Completion Rate (%) | Severe Exacerbation History of the Participants in the Preceding Year | Telemonitoring Intervention | Telemonitoring Data | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
IG | CG | IG | CG | IG | CG | IG | CG | IG | CG | |||||
Boer (2019) [41] | 12 | 43 | 44 | 58 | 66 | 69.3 | 65.9 | 53.0% | 52.1% | 81 | 93 | NI | Used smartphone App & focused on SM | SpO2, HR, BP, Symptoms, Spirometry |
Walker (2018) [40] | 9 | 154 | 158 | 66 | 66 | 71 | 71 | 50.4% | 49.4% | 71 | 77 | Yes | ST | Respiratory mechanical impedance. SpO2, BP and HR for CHF patient. |
Farmer (2017) [39] | 12 | 110 | 56 | 62 | 61 | 69.8 | 69.8 | 47.4% | 50.1% | 85 | 86 | NI | Used android tablet App with educational video | SpO2, HR, Meds, Symptoms |
Cordova (2016) [36] | 24 | 39 | 40 | 50 | 27 | 64 | 63 | 31.0% | 32.0% | 87 | 83 | Yes | Self-Report using PDA | Peak flow rate, BT, Symptoms |
Ho (2016) [37] | 6 | 53 | 53 | 81 | 72 | 81.4 | 79 | 62.0% | 62.0% | 100 | 100 | Yes (H) | ST | BW, SpO2, HR, BP, Symptoms |
Vianello (2016) [38] | 12 | 230 | 104 | 71 | 73 | 76 | 76.5 | 41.9% | 41.9% | 79 | 78 | Yes | ST | SpO2, HR |
McDowell (2015) [34] | 6 | 55 | 55 | 42 | 46 | 69.8 | 70.2 | 45.5% | 43.4% | 87 | 95 | Yes | ST | SpO2, HR, BP, Symptoms |
Ringbæk (2015) [35] | 6 | 141 | 140 | 39 | 55 | 69.8 | 69.4 | 34.9% | 33.8% | 88 | 89 | Yes (H) | ST with video conference | Spirometry, SpO2, Symptoms |
Bentley (2014) [32] | 14 | 32 | 31 | 42.9 | 28 | 67.2 | 65.9 | NI | NI | 72 | 80.6 | Yes | ST | SpO2, HR, BP, Symptoms |
Segrelles Calvo (2014) [33] | 7 | 30 | 30 | 76 | 73 | 75 | 72.7 | 38.3% | 37.1% | 90 | 87 | Yes | ST | BP, SpO2, HR, Peak flow rate |
De San Miguel (2013) [19] | 6 | 40 | 40 | 39 | 57 | 71 | 74 | Home O2 | Home O2 | 90 | 88 | NI | ST | BP, BT, HR, O2 flow rate, SpO2, Symptoms |
Paré (2013) [42] | 21.5 | 60 | 60 | 32 | 32 | 67.8 | 68.6 | <45.0% | <45.0% | 100 | 100 | Yes | ST & focused on SM | Meds, Symptoms |
Pedone (2013) [30] | 9 | 50 | 49 | 72 | 63 | 74.1 | 75.4 | 52.5% | 55.4% | 78 | 100 | NI | ST | SpO2, HR, BT, Physical activity |
Pinnock (2013) [29] | 12 | 128 | 128 | 41 | 49 | 69.4 | 68.4 | 44.0% | 40.0% | 82 | 78 | Yes | ST | SpO2, Meds, Symptoms |
Sorknaes (2013) [31] | 26 | 132 | 134 | 40 | 38 | 71 | 72 | 33.0% | 37.0% | 92 | 90 | Yes (H) | ST with video conference | HR, SpO2, Spirometry, Symptoms |
Antoniades (2012) [26] | 12 | 22 | 22 | 45 | 45 | 70 | 68 | 0.91 L | 0.66 L | 73 | 91 | Yes | ST | Spirometry, BW, BT, BP, SpO2, ECG, Meds, Symptoms |
Chau (2012) [27] | 2 | 30 | 23 | 96 | 100 | 73.5 | 72.2 | 38.0% | 37.7% | 73 | 78 | Yes | ST | Meds, SpO2, HR, RR |
Dinesen (2012) [28] | 10 | 60 | 51 | NI | NI | 68 | 68 | 0.90L | 0.93L | 95 | 94 | NI | ST with tele-rehab via video conference | BP, HR, BW, SpO2, Spirometry |
Lewis (2010) [18] | 6 | 20 | 20 | 50 | 50 | 67 | 70 | 38.0% | 40.0% | 100 | 100 | NI | ST & post-PR patients only | BT, SpO2, Symptoms |
Shany (2010) [25] | 12 | 21 | 21 | 48 | 43 | 72.1 | 74.2 | NI | NI | 62 | 86 | NI | ST | BP, Spirometry, ECG, SpO2, BW, BT, Symptoms |
Koff (2009) [24] | 3 | 20 | 20 | 45 | 50 | 66.6 | 65 | 33.6% | 31.1% | 95 | 95 | NI | ST & focused on SM | SpO2, FEV1, 6MWD, Symptoms |
de Toledo (2006) [23] | 12 | 67 | 90 | NI | NI | 71 | 72 | 42.0% | 42.0% | 100 | 100 | Yes (H) | ST with video conference | ECG, SpO2, Spirometry, BP, HR, Symptoms |
1st Author (Year) | Primary Outcomes | Secondary Outcomes (Measurement Tools) | |||
---|---|---|---|---|---|
Adm. no. (Adm. Rate) | Adm. Duration | Time to 1st Adm. | ER Visit No. | ||
Boer (2019) [41] | NS | Self-efficacy & self-management action: →; Health status (NCSI): →; QoL: (1) CCQ: → & (2) EQ-5D: → | |||
Walker (2018) [40] | (NS) | NS | QoL: EQ-5D: →; Costs: →; Re-Adm: ↓ | ||
Farmer (2017) [39] | NS | QoL: (1) SGRQ: → & (2) EQ-5D: ↑; Mortality: →; Nurse contact: ↓ | |||
Cordova (2016) [36] | NS (NS) | NS | NS | Dyspnoea ↓ & PEFR: ↑; Mortality: →; QoL: (1) SGRQ: ↑ & (2) SF-36: ↑ | |
Ho (2016) [37] | NS | ↑ | NS | All-cause admissions and ER visits: ↓ | |
Vianello (2016) [38] | (NS) | NS | NS | Anxiety & Depression (HADS): →; QoL (SF-36): →; Mortality: →; Re-Adm for all-cause and COPD: ↓ | |
McDowell (2015) [34] | NS | NS | NS | Anxiety ↓ & Depression → (HADS); Costs: →; User satisfaction: ↑; QoL: (1) SGRQ: ↑ & (2) EQ-5D: → | |
Ringbæk (2015) [35] | NS | NS | NS | NS | Mortality: → |
Bentley (2014) [32] | ↑ | ↑ | ↓ | QoL (SGRQ): ↑; Costs: ↓ only if admission data were excluded; Mortality: → | |
Segrelles Calvo (2014) [33] | ↓ | ↓ | ↑ | ↓ | User satisfaction: ↑ |
De San Miguel (2013) [19] | NS | NS | NS | Cost: ↓; User satisfaction: ↑; QoL (CRQ): → | |
Paré (2013) * [42] | NS | ↓ | NS | Costs: ↓; User satisfaction: ↑ | |
Pedone (2013) [30] | (↓) | Rate of respiratory events: ↓ | |||
Pinnock (2013) [29] | NS | NS | NS | Anxiety & Depression (HADS): →; Knowledge (LINQ): →; Self-efficacy (SECD6): →; Mortality: →; QoL (SGRQ): → | |
Sorknaes (2013) [31] | NS | NS | NS | Mortality: → | |
Antoniades (2012) [26] | NS | NS | 6MWD: →; QoL: (1) CRDQ: → & (2) SF-36: → | ||
Chau (2012) [27] | NS | NS | User satisfaction: ↑; Spirometry: →; QoL (CRQ): → | ||
Dinesen (2012) [28] | (NS) | NS | Cost: → | ||
Lewis (2010) [18] | NS | NS | NS | User satisfaction: ↑; PCP contact ↓ | |
Shany (2010) [25] | NS | NS | NS | Anxiety & Depression (HADS): →; QoL (SGRQ): →; User Satisfaction (Questionnaire): ↑ | |
Koff (2009) [24] | ↓ | ↓ | Cost: tend to ↓; User satisfaction: ↑; QoL (SGRQ): ↑ | ||
de Toledo (2006) [23] | ↓ | ↑ | NS | Cost ↓; Mortality: →; Acceptability to professionals ↑ |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jang, S.; Kim, Y.; Cho, W.-K. A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations. Int. J. Environ. Res. Public Health 2021, 18, 6757. https://doi.org/10.3390/ijerph18136757
Jang S, Kim Y, Cho W-K. A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations. International Journal of Environmental Research and Public Health. 2021; 18(13):6757. https://doi.org/10.3390/ijerph18136757
Chicago/Turabian StyleJang, Sujin, Youngmee Kim, and Won-Kyung Cho. 2021. "A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations" International Journal of Environmental Research and Public Health 18, no. 13: 6757. https://doi.org/10.3390/ijerph18136757