JMIR Publications

ABSTRACT

Background:

Many patients with COPD or asthma experience exacerbations leading to hospitalizations, impacting quality of life and straining healthcare systems. Telemonitoring emerged as a substitute for outpatient clinic visits, aiming to intervene early and prevent hospitalization. Real-world evidence is needed to understand how telemonitoring functions in routine clinical practice.

Objective:

This study aims to describe and compare patient characteristics and clinical outcomes of patients with COPD or asthma who received telemonitoring versus conventional care based on real-world data.

Methods:

An observational retrospective cohort study was conducted with data from newly diagnosed COPD or asthma patients who received telemonitoring or conventional care with up to one-year follow-up. Outcomes included patient characteristics, COPD or asthma related hospitalizations, emergency department (ED) visits, exacerbations and outpatient clinic visits.

Results:

The study included 614 patients in conventional care and 96 in telemonitoring. Telemonitoring users are younger, predominantly female, rarely current smokers and have fewer comorbidities. More asthma patients used telemonitoring compared to COPD patients. Patients using telemonitoring showed more moderate exacerbations (IRR 2.15 [1.16-3.98], P =.02). Although telemonitoring users experienced fewer hospitalizations, this was not significant after adjusting for confounders (IRR 0.68 [0.15-3.11], P =.62). Telemonitoring users had more telephone and screen-to-screen consultations (IRR 7.16 [5.47-9.36], P <.001), but outpatient clinic visits remained consistent across both groups (IRR 1.19 [0.88-1.62] P =.27).

Conclusions:

Patient characteristic differences and clinical outcome differences were identified between telemonitoring and conventional care. Despite early prescription of antibiotics or prednisone in the telemonitoring group, there was no reduction in ED visits or hospitalizations. No decrease in outpatient clinic visits was observed for telemonitoring patients; however, there was an increase in telephone consultations. More insight is needed into factors influencing participation in telemonitoring to better serve current users and improve accessibility for non-users. While telemonitoring may lead to increased healthcare utilization, the value of improved access to care and quality of life should also be considered.