A RCT of telehealth for COPD patient's Quality of life: The Whole System Demonstrator Evaluation

Rixon, L., Hirani, S. P., Cartwright, M., Beynon, M., Doll, H., Steventon, A., Henderson, C. & Newman, S. P. (2015). A RCT of telehealth for COPD patient's Quality of life: The Whole System Demonstrator Evaluation. The Clinical Respiratory Journal, 11(4), pp. 459-469. doi: 10.1111/crj.12359

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Abstract

INTRODUCTION/OBJECTIVES: Despite some concerns that the introduction of telehealth (TH) may lead to reductions in quality of life (QoL), lower mood and increased anxiety in response to using assistive technologies to reduce health care utilisation and manage long term conditions, this research focuses on the extent to which providing people with tools to monitor their condition can improve QoL.

METHODS: The Chronic Obstructive Pulmonary Disease cohort of the Whole Systems Demonstrator Trial is a pragmatic General Practitioner (GP) clustered RCT evaluating TH in the UK from three regions in England. All patients at a participating GP practice were deemed eligible for inclusion in the study if they were diagnosed with COPD.

RESULTS: 447 participants completed baseline and either a short (4 months) or long term (12 months) follow up. There was a trend of improved QoL and mood in the TH group at longer-term follow up, but not short term follow up. Emotional functioning (g= 0.280 95% CI, 0.051- 0.510) and mastery reached (g= 2.979 95%CI, 0- 0.46) significance at P<0.05 (all Hedges g <0.3).

CONCLUSIONS: TH showed minimal benefit to QoL in COPD patients who were not preselected to be at increased risk of acute exacerbations. Benefits were more likely in disease specific measures at longer term follow up. TH is a complex intervention and should be embedded in a service that is evidenced based. Outcome measures must be sensitive enough to detect changes in the target population for the specific intervention. This article is protected by copyright. All rights reserved.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Rixon, L., Hirani, S. P., Cartwright, M., Beynon, M., Doll, H., Steventon, A., Henderson, C. & Newman, S. P. A RCT of telehealth for COPD patient's Quality of life: The Whole System Demonstrator Evaluation. The Clinical Respiratory Journal, which is published in final form at http://dx.doi.org/10.1111/crj.12359. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: Telehealth; self-monitoring; self-management; Quality of life; Patient Reported Outcomes (PRO); COPD
Subjects: R Medicine
Divisions: School of Health Sciences
URI: http://openaccess.city.ac.uk/id/eprint/12377

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