Home Telehealth Uptake and Continued Use Among Heart Failure and Chronic Obstructive Pulmonary Disease Patients: a Systematic Review

Background Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved. Purpose The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth. Methods This research performs a narrative synthesis of the results from included studies. Results Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified. Conclusions Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth

Community health programs delivered through information and communications technology in high-income countries : Scoping review

Background: The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges. Objective: The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals. Methods: The Joanna Briggs Institute’s scoping review methodology guided the review of the literature. Results: The search retrieved 7110 unique citations. Each title and abstract was screened by at least two reviewers, resulting in 399 citations for full-text review. Of these 399 citations, 72 (18%) were included. An additional 27 citations were identified through reviewing the reference lists of the included studies, resulting in 99 citations. Citations examined 83 ICT-delivered programs from 19 high-income countries. Variations in program design, ICT platforms, research design, and outcomes were evident. Conclusions: Included programs and research were heterogeneous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared with participants receiving in-person programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers

Early telemedicine training and counselling after hospitalization in patients with severe chronic obstructive pulmonary disease: A feasibility study

Background: An essential element in the treatment of patients with chronic obstructive pulmonary disease (COPD) is rehabilitation, of which supervised training is an important part. However, not all individuals with severe COPD can participate in the rehabilitation provided by hospitals and municipal training centres due to distance to the training venues and transportation difficulties. The aim of the study was to assess the feasibility of an individualized home-based training and counselling programme via video conference to patients with severe COPD after hospitalization including assessment of safety, clinical outcomes, patients' perceptions, organisational aspects and economic aspects.  Methods: The design was a pre- and post-test intervention study. Fifty patients with severe COPD were included. The telemedicine training and counselling included three weekly supervised exercise sessions by a physiotherapist and up to two supervised counselling and training sessions in energy conservation techniques by an occupational therapist. The telemedicine videoconferencing equipment was a computer containing a screen, a microphone, an on/off switch and a volume control.  Results: Thirty seven (74%) participants completed the programme, with improvements in health status assessed by the Clinical COPD Questionnaire and physical performance assessed by a sit-to-stand test and a timed-up-and-go test. There were no cases of patient fall or emergency contact with a general practitioner during the telemedicine training sessions. The study participants believed the telemedicine training and counselling was essential for getting started with being physically active in a secure manner. The business case showed that under the current financing system, the reimbursement to the hospital was slightly higher than the hospital expenditures. Thus, the business case for the hospital was positive. The organizational analysis indicated that the perceptions of the staff were that the telemedicine service had improved the continuity of the rehabilitation programme for the patients and enabled the patients' everyday lives to be included in the treatment.  Conclusions: This study showed that home-based supervised training and counselling via video conference is safe and feasible and that telemedicine can help to ensure more equitable access to supervised training in patients with severe COPD.  Trial registration: Clinical Trials NCT02085187 (Date of registration 10.03.2014)

eHealth in Chronic Diseases

This book provides a review of the management of chronic diseases (evaluation and treatment) through eHealth. Studies that examine how eHealth can help to prevent, evaluate, or treat chronic diseases and their outcomes are included

Impact of Telemedicine in Management of Chronic Diseases

ABSTRACT  Diagnosis of chronic diseases have an impact on patient’s quality of life and the healthcare system. Telemedicine facilitates the delivery of medical intervention at home to improve health outcomes and reduces cost to the NHS. Adoption of telemedicine for routine management of chronic diseases impacts the healthcare patients and healthcare professionals, however, there are several challenges affecting the adoption of telemedicine into routine healthcare delivery. Lack of universal regulations and quality assurance protocol can impact the widescale implementation of telemedicine into routine healthcare. Therefore, further research, support and training is required for successful adoption for routine management of chronic diseases

Clinical users' perspective on telemonitoring of patients with long term conditions: Understood through concepts of Giddens's structuration theory & consequence of modernity

This is the post-print version of the article - Copyright @ 2010 IOS.This study involves conducting focus group discussions with clinical users (nurses and technicians) prior to the launch of telehealth service in Nottingham, UK, to elicit their initial perceptions about the service. It describes the findings from preliminary phase of otherwise a larger longitudinal study. Using Giddens’s concepts from structuration theory and con-sequence of modernity, we were able to acknowledge trust and sense of security as two very salient aspects that govern adop-tion of new technological innovation. Unattended, these as-pects contribute to arousal of conflict and contradiction within a system. In order for successful telehealth implementa-tions in health care setting, providers of the service, need to focus on ways in which clinical users’ trust can be gained and sense of security can be promoted while using the telehealth service and technology.Funding was obained from MATCH (Multidisciplinary Assessment of Technologies Centre for Healthcare)

A randomised controlled trial testing a web-based, computer-tailored self-management intervention for people with or at risk for chronic obstructive pulmonary disease: a study protocol

Contains fulltext : 125231.pdf (publisher's version ) (Open Access)BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality. Effective self-management support interventions are needed to improve the health and functional status of people with COPD or at risk for COPD. Computer-tailored technology could be an effective way to provide this support. METHODS/DESIGN: This paper presents the protocol of a randomised controlled trial testing the effectiveness of a web-based, computer-tailored self-management intervention to change health behaviours of people with or at risk for COPD. An intervention group will be compared to a usual care control group, in which the intervention group will receive a web-based, computer-tailored self-management intervention. Participants will be recruited from an online panel and through general practices. Outcomes will be measured at baseline and at 6 months. The primary outcomes will be smoking behaviour, measuring the 7-day point prevalence abstinence and physical activity, measured in minutes. Secondary outcomes will include dyspnoea score, quality of life, stages of change, intention to change behaviour and alternative smoking behaviour measures, including current smoking behaviour, 24-hour point prevalence abstinence, prolonged abstinence, continued abstinence and number of quit attempts. DISCUSSION: To the best of our knowledge, this will be the first randomised controlled trial to test the effectiveness of a web-based, computer-tailored self-management intervention for people with or at risk for COPD. The results will be important to explore the possible benefits of computer-tailored interventions for the self-management of people with or at risk for COPD and potentially other chronic health conditions. DUTCH TRIAL REGISTER: NTR3421