Technology-Enabled Self-Management of Chronic Obstructive Pulmonary Disease With or Without Asynchronous Remote Monitoring: Randomized Controlled Trial
Autor: | Katrina Engel, Florence van Lieshout, Payal Agarwal, R. Sacha Bhatia, Rebecca Yang, James Shaw, Aman Sidhu, Kyle Liang, Angelica Cheung, Vess Stamenova, Elizabeth Lalingo, Onil Bhattacharyya, Maria Radina, Adam Erwood, Roshan Shafai, Allen Greenwald |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Technology medicine.medical_treatment Respiratory therapist Health Informatics lcsh:Computer applications to medicine. Medical informatics law.invention 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Randomized controlled trial law Health care self-care medicine Outpatient clinic COPD Humans Pulmonary rehabilitation 030212 general & internal medicine Aged Remote Consultation Original Paper business.industry lcsh:Public aspects of medicine Self-Management lcsh:RA1-1270 Emergency department Monitoring program 030228 respiratory system Emergency medicine Quality of Life lcsh:R858-859.7 eHealth Female telemedicine business |
Zdroj: | Journal of Medical Internet Research Journal of Medical Internet Research, Vol 22, Iss 7, p e18598 (2020) |
ISSN: | 1438-8871 1439-4456 |
Popis: | Background Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and leads to frequent hospital admissions and emergency department (ED) visits. COPD exacerbations are an important patient outcome, and reducing their frequency would result in significant cost savings. Remote monitoring and self-monitoring could both help patients manage their symptoms and reduce the frequency of exacerbations, but they have different resource implications and have not been directly compared. Objective This study aims to compare the effectiveness of implementing a technology-enabled self-monitoring program versus a technology-enabled remote monitoring program in patients with COPD compared with a standard care group. Methods We conducted a 3-arm randomized controlled trial evaluating the effectiveness of a remote monitoring and a self-monitoring program relative to standard care. Patients with COPD were recruited from outpatient clinics and a pulmonary rehabilitation program. Patients in both interventions used a Bluetooth-enabled device kit to monitor oxygen saturation, blood pressure, temperature, weight, and symptoms, but only patients in the remote monitoring group were monitored by a respiratory therapist. All patients were assessed at baseline and at 3 and 6 months after program initiation. Outcomes included self-management skills, as measured by the Partners in Health (PIH) Scale; patient symptoms measured with the St George’s Respiratory Questionnaire (SGRQ); and the Bristol COPD Knowledge Questionnaire (BCKQ). Patients were also asked to self-report on health system use, and data on health use were collected from the hospital. Results A total of 122 patients participated in the study: 40 in the standard care, 41 in the self-monitoring, and 41 in the remote monitoring groups. Although all 3 groups improved in PIH scores, BCKQ scores, and SGRQ impact scores, there were no significant differences among any of the groups. No effects were observed on the SGRQ activity or symptom scores or on hospitalizations, ED visits, or clinic visits. Conclusions Despite regular use of the technology, patients with COPD assigned to remote monitoring or self-monitoring did not have any improvement in patient outcomes such as self-management skills, knowledge, or symptoms, or in health care use compared with each other or with a standard care group. This may be owing to low health care use at baseline, the lack of structured educational components in the intervention groups, and the lack of integration of the action plan with the technology. Trial Registration ClinicalTrials.gov NCT03741855; https://clinicaltrials.gov/ct2/show/ NCT03741855 |
Databáze: | OpenAIRE |
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