There is little evidence that telemedicine interventions consistently improve the quality of life of COPD patients, according to a new systematic review published recently in the International Journal of Chronic Obstructive Pulmonary Disease. Researchers looked at 47 studies of telemedicine use in COPD since 2000 and analyzed 18 that met their inclusion criteria. Of those, just three showed a statistically significant improvement in quality of life.
"Telehealth does not make a strong case for itself when exclusively looking at QoL as an outcome, since statistically significant improvements relative to control groups have been observed only in few of the available studies," researchers wrote. "Nonetheless, this does not only rule out the possibility that telehealth is superior to standard care with regard to other outcomes but also seems to call for more research, not least in large-scale controlled trials."
Researchers also observed that there were three distinct categories of telemedicine intervention, and all three of the studies that showed a quality of life improvement fit into the same one. Interventions could be divided, researchers wrote, into those that simply provided standard care remotely via telemedicine, those that added a passive element like monitoring, and those that added an active element like coaching or skills training. Only active interventions returned results.
Another observation made was that, even though only a few studies showed a measurable improvement in quality of life, none registered a measurable drop; which is to say, in none of the 18 studies did a telemedicine study make a patient's quality of life worse.
"Is it at all reasonable to expect, or even demand, an improvement in QoL from the implementation of telehealth?" researchers asked, suggesting a question to be explored in future studies. "Is it a realistic success criterion? Among the studies considered here, those that examined the use of telemonitoring in addition to standard care all failed at improving QoL in the intervention group compared to the control group, as did telemedical pulmonary rehabilitation as compared to standard outpatient pulmonary rehabilitation and telemedical treatment for exacerbations of COPD as compared to standard in-hospital treatment. Nonetheless, it is important to note that none of the studies observed a significant decrease in QoL in the intervention groups when compared to the control groups."