Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 28, 2021
Date Accepted: Jan 17, 2023
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Telehealth Interventions for COPD Management: An Umbrella Review
ABSTRACT
Background:
Chronic obstructive pulmonary disease (COPD) is a growing epidemic, with a heavy associated economic burden. Education, physical activity, and pulmonary rehabilitation programs are important aspects of the management of COPD. These interventions are commonly delivered remotely as part of telemedicine interventions. Several systematic reviews and meta-analyses have been conducted to assess the effectiveness of these interventions. However, these reviews often have conflicting conclusions.
Objective:
We thus sought to conduct an umbrella review to critically appraise and summarise the available evidence on telemedicine interventions for the management of COPD.
Methods:
Medline, Embase, Scopus, Web of Science, PsycINFO and Cochrane databases were searched for articles relating to telemedicine interventions for the management of COPD. We included systematic reviews and meta-analyses of randomised controlled trials which compared telemedicine interventions to usual care. A narrative synthesis was performed.
Results:
We identified 10 systematic reviews which met the inclusion criteria. Telemedicine interventions used in these reviews were tele treatment, telemonitoring and tele support. Tele support interventions significantly reduced the number of inpatient days and quality of life. Tele monitoring interventions were associated with significant reductions in respiratory exacerbations and hospitalisation rate. Tele treatment showed significant effectiveness in reducing respiratory exacerbations, respiratory exacerbations, hospitalisation rate, compliance (acceptance and dropout rate) and physical activity. Among studies which used integrated telemedicine interventions, there was a significant improvement in physical activity.
Conclusions:
Telemedicine interventions showed non-inferiority or superiority over standard of care for the management of COPD. Telemedicine interventions should be considered as a supplement to usual methods of care for the outpatient management of COPD, with the aim of reducing the burden on healthcare systems.
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