Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 23, 2025
Date Accepted: May 9, 2025
Clinical and cost-effectiveness of telehealth-supported home oxygen therapy on adherence, hospital readmission, and health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis of randomized controlled trials
ABSTRACT
Background:
Tele-monitoring and management play a crucial role in optimizing home oxygen therapy for patients with chronic obstructive pulmonary disease. As the use of tele-monitoring to improve adherence, reduce hospital readmissions, and enhance health-related quality of life grows, existing evidence remains inconsistent and warrants further examination.
Objective:
This study aims to evaluate the clinical and cost-effectiveness of telehealth-supported home oxygen therapy on adherence, hospital readmission, and health-related quality of life in patients with chronic obstructive pulmonary disease.
Methods:
A comprehensive search was conducted across six databases (PubMed, Cochrane Central, Embase, Web of Science, PsycINFO, and CINAHL) through October 1, 2024. Meta-analysis and heterogeneity testing were performed using R software, and standardized mean differences with 95% confidence intervals were calculated to assess intervention effects.
Results:
Seven studies, involving 1,230 patients, were included in the analysis. Telehealth-supported home oxygen therapy significantly reduced hospital readmissions (SMD: −0.40, 95% CI: [−0.60, −0.21]) and improved health-related quality of life (SMD: 0.44, 95% CI: [0.15, 0.72]). However, it did not have a significant impact on therapy adherence (SMD: 0.19, 95% CI: [−0.76, 1.14]). Sensitivity analysis confirmed the stability of the results for hospital readmission. Additionally, three economic studies indicated that while telehealth interventions may involve higher initial costs, they are likely to lead to long-term savings by reducing hospital admissions.
Conclusions:
Telehealth-supported home oxygen therapy significantly reduces hospital admissions and improves health-related quality of life among patients with chronic obstructive pulmonary disease. However, it does not significantly enhance adherence. Tailored interventions, designed to address patient demographics, combined with supportive policies, could further improve outcomes. Future studies should incorporate economic evaluations to guide policy decisions regarding the implementation of telehealth-supported home oxygen therapy. Clinical Trial: PROSPERO CRD42024598539
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