Abstract
Only a minority of patients with chronic obstructive pulmonary disease (COPD) have access to pulmonary rehabilitation (PR). Home-based solutions, e.g. telehealthcare, have been used in efforts to make PR more available.
Aim: To investigate the effects of telehealthcare on physical activity level, physical capacity and dyspnea in patients with COPD, and to describe the interventions.
Methods: Studies were identified through database searches, reference lists and contacts with included authors. Abstracts and articles were reviewed based on eligibility criteria by three authors. Risk of bias was individually assessed by two authors. Standardized mean differences (SMD) with 95% CI were calculated. Forest plots were used to present data visually.
Results: Eleven studies (ten RCT) with a total of 1051 patients were included. Regular phone calls was the most common intervention. Rehabilitation promoted through websites or mobile phones was also used. Telehealthcare was often combined with education and/or exercise training. Comparators were ordinary care, exercise training and/or education. For dyspnea there was a small significant effect favoring telehealthcare (SMD, 0.147; 95% CI, 0.015-0.279). For physical activity level (SMD, 0.328; 95% CI, -0.053-0.709) and physical capacity (SMD, 0.147; 95% CI, -0.094-0.387) a positive trend favoring telehealthcare, although not significant, was found.
Conclusions: The use of telehealthcare can lead to improvements in dyspnea and seems to be promising also for improving physical activity level and physical capacity. More studies with the aim to evaluate telehealthcare as main intervention would be of benefit.
- © 2014 ERS