Telehealth Technology: An Emerging Method of Delivering Pulmonary Rehabilitation to Patients with Chronic Obstructive Pulmonary Disease
Notice bibliographique
Résumé
(pages 216-220), Stickland et al (2) examined the efficacy of an outpatient pulmonary rehabilitation (PR) program delivered via Telehealth technology (Telehealth-PR) and compared it with PR delivered in person through a standard out-patient, hospital-based program. Using a parallel group, noninferior-ity experimental design, the authors demonstrated that the two programs resulted in similar improvements in quality of life and func-tional capacity.Telehealth is an option particularly for those living in isolated areas or who are unable to access transportation to hospital or out-patient programs (3). Although there is some evidence to support Telehealth in chronic obstructive pulmonary disease (COPD), there is little information regarding the delivery of rehabilitation in this population. With respect to Telehealth, Polisena et al (4) completed a systematic review of 10 articles describing 858 patients with COPD. Four studies compared home telemonitoring with usual care, while six randomized controlled trials compared telephone support with usual care. There was considerable variability among studies in terms of interventions and approach. The results showed that home Telehealth (home telemonitoring and telephone support) decreased the rates of hospitalization and emergency department visits, while findings for hospital bed days of care varied among studies. Another systematic review of this topic by Bartoli et al (5) reported that telemonitoring, consisting of routine data transmission between the patient’s home and a healthcare professional located in the hospital, was the most common service provided by Telehealth in individuals with COPD. Within the realm of rehabilitation, Lewis et al (6) examined whether telemonitoring after PR impacted health care use. They ran-domly assigned patients who had completed at least 12 sessions of outpatient PR who were also stable with moderate to severe COPD to receive standard care or telemonitoring. Health care professionals could access the data and receive alerts if there were concerns. There were fewer primary care contacts for respiratory issues in the Telehealth group, but no differences between the groups in emergency room visits, hospital admissions, days in hospital or contacts to the specialist COPD community nurse team. The trial by Stickland et al (2) is unique in that it addressed the delivery of PR rather than simply monitoring it. The individuals in the Telehealth-PR program were assessed by teleconferencing for their suitability for PR. They subsequently attended PR twice a week for eight weeks within their local community where they performed group exercises for 2 h and received education (via teleconferencing) for 1 h. The patients exercised in groups of two to six, and were supervised by a local health care professional. This model has the potential to increase accessibility to PR, especially for those in isolated areas with no access to large centres, but still allowing social interaction provided by a group setting and supervision from a health care professional. In summary, the results of the study by Stickland et al provide evi-dence in support of one Telehealth model for the delivery of PR. Future studies are needed to examine the long-term efficacy of this intervention after one year and beyond, and to explore other Telehealth models, pos-sibly within the home, for delivery of rehabilitation. ©2011 Pulsus Group Inc. All rights reserved
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,005 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».