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
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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 ↑ |
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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
APA StyleJang, S., Kim, Y., & Cho, W. -K. (2021). A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations. International Journal of Environmental Research and Public Health, 18(13), 6757. https://doi.org/10.3390/ijerph18136757