Telehealthcare for patients suffering from chronic obstructive pulmonary disease: effects on health-related quality of life: results from the Danish ‘TeleCare North’ cluster-randomised trial

• Published in: BMJ open 2017-05, Vol.7 (5), p.e014587
• Main Authors: Lilholt, Pernille Heyckendorff, Witt Udsen, Flemming, Ehlers, Lars, Hejlesen, Ole K
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Blood pressure; Chronic illnesses; Chronic obstructive pulmonary disease; Denmark - epidemiology; Disease Progression; Dyspnea; Evidence-based medicine; Female; Health Informatics; Health Status; Hospitalization - statistics & numerical data; Humans; Intervention; Logistic Models; Male; Medical research; Middle Aged; Patients; Pulmonary Disease, Chronic Obstructive - therapy; Pulse oximetry; Quality of Life; Questionnaires; Systematic review; Telemedicine; Vital signs
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2016-014587

ObjectiveTo assess the effect of telehealthcare compared with usual practice in patients with chronic obstructive pulmonary disease (COPD).DesignA cluster-randomised trial with 26 municipal districts that were randomly assigned either to an intervention group whose members received telehealthcare in addition to usual practice or to a control group whose members received usual practice only (13 districts in each arm).SettingTwenty-six municipal districts in the North Denmark Region of Denmark.ParticipantsPatients who fulfilled the Global Initiative for COPD guidelines and one of the following criteria: COPD Assessment Test score ≥10; or Medical Research Dyspnoea Council Scale ≥3; or Modified Medical Research Dyspnoea Council Scale ≥2; or ≥2 exacerbations during the past 12 months.Main outcome measuresHealth-related quality of life (HRQoL) assessed by the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form 36-Item Health Survey, Version 2. Data were collected at baseline and at 12 month follow-up and analysed according to the intention-to-treat principle with complete cases, n=574 (258 interventions; 316 controls) and imputed data, n=1225 (578 interventions, 647 controls) using multilevel modelling.ResultsIn the intention-to-treat analysis (n=1225), the raw mean difference in PCS from baseline to 12 month follow-up was −2.6 (SD 12.4) in the telehealthcare group and −2.8 (SD 11.9) in the usual practice group. The raw mean difference in MCS scores in the same period was −4.7 (SD 16.5) and −5.3 (SD 15.5) for telehealthcare and usual practice, respectively. The adjusted mean difference in PCS and MCS between groups at 12 months was 0.1 (95% CI −1.4 to 1.7) and 0.4 (95% CI −1.7 to 2.4), respectively.ConclusionsThe overall sample and all subgroups demonstrated no statistically significant differences in HRQoL between telehealthcare and usual practice.Trial registration numberNCT01984840; Results.