The Health Diary Telemonitoring and Hospital-Based Home Care Improve Quality of Life Among Elderly Multimorbid COPD and Chronic Heart Failure Subjects

Abstract

Background

Elderly, multimorbid patients with advanced chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF) exhibit poor health-related quality of life (HRQoL). Telemonitoring, based on digital pen technology, supported by hospital-based home care (HBHC) significantly reduces the number of hospitalizations. We hypothesized that the same intervention would prevent the deterioration of HRQoL that follows upon disease progression.

Methods

Elderly computer-illiterate subjects with ≥2 hospitalizations the previous year were included. HRQoL was assessed at inclusion (baseline) and at 1, 6 and 12 months employing EuroQol-5 Dimensions (EQ-5D) and RAND-36 for general HRQoL, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) and St. Georges Respiratory Questionnaire (SGRQ) for disease-specific HRQoL. Healthcare contacts, hospitalizations, as-needed medications, prescription changes and healthcare costs were registered.

Results

Ninety-four patients were enrolled of which 53 subjects completed the 12-month study period. Compared to baseline, most domains of RAND-36 were improved significantly at 1 time-point or more. Only among COPD subjects, the disease-specific HRQoL was worsened at the 12 month evaluation. Measures of healthcare dependency were associated with poor HRQoL.

Conclusion

The Health Diary system and HBHC together improve general HRQoL, and measures of healthcare dependency are associated with HRQoL variables.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 09 March 2020

Publication date Collection: 2020

Volume: 15

Pages: 527-541

Affiliations

[1 ]Department of Respiratory Medicine in Linköping, Linköping University , Linköping SE-581 85, Sweden

[2 ]Department of Biomedical and Clinical Sciences, Linköping University , Linköping SE-581 85, Sweden

[3 ]Research and Development Unit in Region Östergötland, Linköping University , Linköping SE-581 85, Sweden

[4 ]Department of Health, Medicine and Caring Sciences, Linköping University , Linköping SE-581 85, Sweden

[5 ]Department of Biomedical Engineering/Health Informatics, Linköping University , Linköping SE-581 85, Sweden

[6 ]Digital Systems Division, Department of Industrial Systems, RISE Research Institutes of Sweden, Linköping University , Linköping, S-581 83, Sweden

Author notes

Correspondence: Hans Lennart Persson Department of Respiratory Medicine in Linköping, Linköping University , LinköpingSE-581 85, SwedenTel [phone] Email [e-mail]

Article

Publisher ID: 236192

DOI: 10.2147/COPD.S236192

PMC ID: 7069558

PubMed ID: 32210547

Copyright statement: © 2020 Persson et al.

License:

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Page count

Tables: 6, References: 44, Pages: 15

Categories

Subject: Original Research