Effectiveness of tele-monitoring by patient severity and intervention type in chronic obstructive pulmonary disease patients: A systematic review and meta-analysis
Section snippets
What is already known about the topic?
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Tele-monitoring has recently been used for management of chronic obstructive pulmonary disease patients.
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It can promote interactions between patients and medical teams by monitoring the patient’s symptoms, and may assist with unexpected patient hospitalizations or emergency room visits.
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The conflicting outcomes of systematic reviews are that while some studies require more research to reach definite conclusions, others show a positive effect of tele-monitoring.
What this paper adds
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Our results showed that tele-monitoring reduced emergency room visits, hospitalizations, and the mental health quality of life, while there were no differences in mortality, outpatient visits, or length of stay.
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Tele-monitoring has proved to be more useful in reducing the number of emergency room visits and hospitalization of patients with (very) severe chronic obstructive pulmonary disease than those with moderate diseases.
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Active integrated tele-monitoring, which includes the act of delivering
Search strategy
We performed a systemic review to identify relevant articles that compared the tele-monitoring group with a control group that didn’t receive tele-monitoring for chronic obstructive pulmonary disease using three English databases Ovid-Medline (1946 – May 2017), Ovid-EMBASE(1974-May 2017), and the Cochrane Central Register of controlled Trials (Central). We designed strategies that included Medical Subject Headings (MeSH), keywords such as “Pulmonary Disease, Chronic Obstructive”, “tele
Results
After a full-text review, 24 articles were identified to be relevant for this study. Three additional articles were found by manually searching relevant bibliographies, and 27 publications were finally selected for inclusion in the meta-analysis. (Fig. 1)
Discussion
We included 27 studies related to tele-monitoring for chronic obstructive pulmonary disease at home in our systematic review. Our study is the most updated and comprehensive systematic review, and the only one that analyzed subgroups by patient severity and intervention type. The principal finding of this systematic review is that tele-monitoring reduced emergency room visits, hospitalizations, and the mental health quality of life, but did not make a difference in mortality, outpatient visits,
Conclusion
The cost of care assistance in chronic obstructive pulmonary disease patients is dramatically increasing. Based on this systematic review, tele-monitoring reduced rates of emergency room visits, hospitalization, and the SF-36 mental component summery. Active integrated tele-monitoring including the delivery of coping skills or education online, including pulmonary rehabilitation, is recommended in order to produce significant improvement. This application of integrated tele-monitoring is more
Author contributions
S.H.L. contributed to the design of the study. All authors undertook the searches and screened studies for eligibility, assessed the quality of papers and performed statistical analyses. S.H.L. drafted the manuscript. All authors critically revised the manuscript for important intellectual content and the manuscript and approved the final version.
Competing interests
The authors declare that no competing interests exist.
Funding
This research was supported by the Gachon University research fund of 2017(GCU-2017-0179).
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