Abstract
Objective: To assess the impact of home telemonitoring (TM) on health service use and QOL in severe chronic lung disease patients via a randomised crossover trial with 6 months standard clinical care (control group) and 6 months with additional TM (Philips Motiva).
Method: Participants - 73 patients (47% male, (mean (SD)) age 63 (12) yrs. 39 with COPD FEV1 0.88(0.54)L and 34 with chronic respiratory failure due to other causes FVC 1.14(0.62)L, who had a hospital admission for an exacerbation within previous 6 months, and used domiciliary oxygen or had a SpO2 <90% during previous acute admission. Patients responded to daily symptom questionnaire and monthly questionnaires on health service use/health related QOL, plus recorded SpO2 daily.
Results: Of 61 patients (32 COPD) completing the trial the time to acute admission did not differ between control and TM groups – mean (SD) Control 156 (52) v TM 147 (60) days, p=0.189, and was not affected by intervention order. EuroQol 5D scores, and self-efficacy did not differ between groups. In patients receiving TM first, hospital & home visits increased: self-efficacy decreased. In COPD and anxious patients receiving TM first, depression (HADS) score fell.
Conclusion: Telemonitoring added to optimised standard care neither reduced acute admissions, nor improved QOL in severe chronic respiratory patients. In some health care activity increased on TM. Subgroups eg. COPD patients with depression, or anxious patients may benefit. A more nuanced, personalised approach to TM is advisable in chronic severe respiratory patients before a major roll-out. *Funded by NIHR CLAHRC NW London.
- © 2014 ERS
