Early telemedicine training and counselling after hospitalization in patients with severe chronic obstructive pulmonary disease: a feasibility study

BMC Medical Informatics and Decision Making

Research Article

Claus Duedal Pedersen¹  Kathrine Rayce¹  Jette Krøjgaard Christensen²  Line Willads Hansen³  Kristian Kidholm⁴  Ingrid Louise Titlestad⁵  Lilian Møllegård⁵  Lisbeth Rosenbek Minet⁶  Alison Bowes⁷ 

[1] Department of Clinical Innovation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark;Department of Medicine, Odense University Hospital, Svendborg Hospital, Valdemarsgade 53, 5700, Svendborg, Denmark;Department of Rehabilitation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark;Department of Research and Health Technology Assessment, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark;Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark;Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, JB Winsløws Vej 19, 5000, Odense C, Denmark;Department of Rehabilitation, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark;School of Applied Science, University of Stirling, FK9 4LA, Stirling, Scotland, UK;

关键词: Pulmonary rehabilitation;    Training;    Counselling;    Telemedicine;    Videoconference;    COPD;    Chronic disease;    Internet;   

DOI  :  10.1186/s12911-014-0124-4

 received in 2014-01-21, accepted in 2014-12-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAn essential element in the treatment of patients with chronic obstructive pulmonary disease (COPD) is rehabilitation, of which supervised training is an important part. However, not all individuals with severe COPD can participate in the rehabilitation provided by hospitals and municipal training centres due to distance to the training venues and transportation difficulties. The aim of the study was to assess the feasibility of an individualized home-based training and counselling programme via video conference to patients with severe COPD after hospitalization including assessment of safety, clinical outcomes, patients’ perceptions, organisational aspects and economic aspects.MethodsThe design was a pre- and post-test intervention study. Fifty patients with severe COPD were included. The telemedicine training and counselling included three weekly supervised exercise sessions by a physiotherapist and up to two supervised counselling and training sessions in energy conservation techniques by an occupational therapist. The telemedicine videoconferencing equipment was a computer containing a screen, a microphone, an on/off switch and a volume control.ResultsThirty seven (74%) participants completed the programme, with improvements in health status assessed by the Clinical COPD Questionnaire and physical performance assessed by a sit-to-stand test and a timed-up-and-go test. There were no cases of patient fall or emergency contact with a general practitioner during the telemedicine training sessions. The study participants believed the telemedicine training and counselling was essential for getting started with being physically active in a secure manner. The business case showed that under the current financing system, the reimbursement to the hospital was slightly higher than the hospital expenditures. Thus, the business case for the hospital was positive. The organizational analysis indicated that the perceptions of the staff were that the telemedicine service had improved the continuity of the rehabilitation programme for the patients and enabled the patients’ everyday lives to be included in the treatment.ConclusionsThis study showed that home-based supervised training and counselling via video conference is safe and feasible and that telemedicine can help to ensure more equitable access to supervised training in patients with severe COPD.Trial registrationClinical Trials NCT02085187 (Date of registration 10.03.2014).

【 授权许可】

CC BY   
© Rosenbek Minet et al.; licensee BioMed Central. 2015