Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Franek J. Home telehealth for patients with chronic obstructive pulmonary disease (COPD): an evidence-based analysis. Toronto: Medical Advisory Secretariat (MAS). Volume 12(11). 2012 Authors' objectives The objective of this analysis was to conduct an evidence-based assessment of home telehealth technologies for patients with chronic obstructive pulmonary disease (COPD) in order to inform recommendations regarding the access and provision of these services in Ontario. This analysis was one of several analyses undertaken to evaluate interventions for COPD. The perspective of this assessment was that of the Ontario Ministry of Health and long-term care, a provincial payer of medically necessary health care services. Authors' conclusions Regarding Research Question #1:
- Low to very low quality evidence (according to GRADE) shows non-significant effects or conflicting effects (of significant or non-significant benefit) for all outcomes examined when comparing home telemonitoring to usual care.
- There is a trend towards a significant increase in time free of hospitalization and use of other health care services with home telemonitoring, but these findings need to be confirmed further in randomized trials of high quality.
- There is severe clinical heterogeneity between studies that limits summary conclusions.
- The economic impact of home telemonitoring is uncertain and requires further study.
- Home telemonitoring is largely dependent on local information technologies, infrastructure, and personnel, and thus the generalizability of external findings may be low. Jurisdictions wishing to replicate home telemonitoring interventions should likely test those interventions within their jurisdictional framework before adoption, or should focus on home-grown interventions that are subjected to appropriate evaluation and proven effective.
Regarding Research Question #2:
- Low quality evidence shows significant benefit in favour of telephone only support for self efficacy and ED visits when compared to usual care, but non-significant results for hospitalizations and hospital length of stay.
- There are very serious issues with the generalizability of this evidence and thus additional study is required. Indexing Status Subject indexing assigned by CRD MeSH Pulmonary Disease, Chronic Obstructives; Telemedicine Language Published English Country of organisation Canada English summary An English language summary is available. Address for correspondence Medical Advisory Secretariat, Ontario Ministry of Health and Long Term Care, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 Canada Email: MASinfo.moh@ontario.ca AccessionNumber 32012000634 Date abstract record published 21/09/2012 |
