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      Use, utility and methods of telehealth for patients with COPD in England and Wales: a healthcare provider survey

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          Abstract

          Introduction

          Although the effectiveness of domiciliary monitoring (telehealth) to improve outcomes in chronic obstructive pulmonary disease (COPD) is controversial, it is being used in the National Health Service (NHS).

          Aim

          To explore the use of teleheath for COPD across England and Wales, to assess the perceptions of clinicians employing telehealth in COPD and to summarise the techniques that have been used by healthcare providers to personalise alarm limits for patients with COPD enrolled in telehealth programmes.

          Methods

          A cross-sectional survey consisting of 14 questions was sent to 230 COPD community services in England and Wales. Questions were designed to cover five aspects of telehealth in COPD: purpose of use, equipment type, clinician perceptions, variables monitored and personalisation of alarm limits.

          Results

          65 participants completed the survey from 52 different NHS Trusts. 46% of Trusts had used telehealth for COPD, and currently, 31% still provided telehealth services to patients with COPD. Telehealth is most commonly used for baseline monitoring and to allow early detection of exacerbations, with 54% believing it to be effective. The three most commonly monitored variables were oxygen saturation, heart rate and breathlessness. A variety of methods were used to set alarm limits with the majority of respondents believing that at least 40% of alarms were false.

          Conclusion

          Around one-third of responded community COPD services are using telehealth, believing it to be effective without robust evidence, with a variety of variables monitored, a variety of hardware and varying techniques to set alarm limits with high false alarm frequencies.

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          Most cited references17

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          Home telehealth for chronic obstructive pulmonary disease: a systematic review and meta-analysis.

          We conducted a systematic review of the literature about home telehealth for chronic obstructive pulmonary disease (COPD) compared with usual care. An electronic literature search identified 6241 citations. From these, nine original studies (10 references) relating to 858 patients were selected for inclusion in the review. Four studies compared home telemonitoring with usual care, and six randomized controlled trials compared telephone support with usual care. Clinical heterogeneity was present in many of the outcomes measured. Home telehealth (home telemonitoring and telephone support) was found to reduce rates of hospitalization and emergency department visits, while findings for hospital bed days of care varied between studies. However, the mortality rate was greater in the telephone-support group compared with usual care (risk ratio = 1.21; 95% CI: 0.84 to 1.75). Home telehealth interventions were similar or better than usual care for quality of life and patient satisfaction outcomes.
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            Impact of Prolonged Exacerbation Recovery in Chronic Obstructive Pulmonary Disease

            Exacerbations are important and heterogeneous events in the natural history of chronic obstructive pulmonary disease (COPD).
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              A home telehealth program for patients with severe COPD: the PROMETE study.

              Acute exacerbations of chronic obstructive pulmonary disease (AECOP) are key events in the natural history of the disease. Patients with more AECOPD have worse prognosis. There is a need of innovative models of care for patients with severe COPD and frequent AECOPD, and Telehealth (TH) is part of these programs.
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                Author and article information

                Journal
                BMJ Open Respir Res
                BMJ Open Respir Res
                bmjresp
                bmjopenrespres
                BMJ Open Respiratory Research
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2052-4439
                2019
                18 February 2019
                : 6
                : 1
                : e000345
                Affiliations
                [1 ] departmentRespiratory Medicine , University College London Medical School , London, UK
                [2 ] departmentRespiratory Care , King Faisal University , Al-Ahsa, Saudi Arabia
                [3 ] departmentRespiratory , Institute for Lung Health , Leicester, UK
                [4 ] departmentRespiratory Care , Jazan University , Jazan, Saudi Arabia
                Author notes
                [Correspondence to ] Ahmed Al Rajeh; ahmed.rajeh.15@ 123456ucl.ac.uk
                Article
                bmjresp-2018-000345
                10.1136/bmjresp-2018-000345
                6424290
                5258f451-a034-4f7d-b0ac-0c6720c18095
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 08 August 2018
                : 17 December 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004686, Deanship of Scientific Research, King Faisal University;
                Categories
                Chronic Obstructive Pulmonary Disease
                1506
                2215
                Custom metadata
                unlocked

                chronic obstructive pulmonary disease,copd,telehealth,home monitoring,alarm limits,perception

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