Home-based telehealth hospitalization for exacerbation of chronic obstructive pulmonary disease: findings from “the virtual hospital” trial.
Source: Jakobsen et al. 2015 - Pubmed ID: 25654366
Setting: Denmark, 2 university hospitals
Study design:
RCT
Follow up: 180 days
Patient group:
Sample size:
Total: 57
IG: 29
CG: 28
Inclusion criteria:
- Severe chronic obstructive pulmonary disease (COPD)
- Acute exacerbation
Type of technology:
Home monitoring
- Touch screen with a Webcam
- Pulse oximeter
- Spirometer
- Thermometer
- Nebulizer for aerosolized inhalation medication
- Oxygen compressor
- Medicine box
Intervention:
Intervention: Home-based telehealth hospitalization for exacerbation (The Virtual Hospital). The patient was prepared for daily ward rounds using the touch screen at appointed hours. Patients were able to perform any particular self-monitoring tasks or regular observations
Duration: 180 days
Add on: NA
Control group: Usual care
Clinical effect:
- Mortality→
- Physiological parameters→
- HRQoL→
Patient safety:
- 1 patient returned owing to technical failure of wireless broadband technology in the home
- 1 patient developed hyponatremia
- 1 patient returned owing to severe dyspnea and nebulizer failure (the patient separated the device by accident
Patient experiences/
Staff experiences:
Patient experience:
- Felt confident using the equipment
- Easy to see the doctor or nurse on the screen, that it was easy to understand the information given, and that they felt their problems were un derstood during ward rounds
- Easy to use the medicine box and that the written in structions given on how to use the equipment were easy to understand
- 4 patients made acute calls
Staff experience:
- 7/8 agreed it was easy to see the patient and to understand the patient’s problems and the patients felt confident using the equipment
- 6/8 agreed feeling confident using the equipment
- 4/8 agreed feeling confident using the equipment
- 5/8 agreed it was easy to work with the telehealth solution
- 4/8 found it easier and less time consuming
Investment:
Equipment
- Measuring devices
- Touch screen
Running:
Equipment
- Measuring devices
- Touch screen
Organization: NA
Health care utilization:
- 30 days readmission for COPD exacerbation→
- 90 days readmission for COPD exacerbation→
- 1800 days readmission for COPD exacerbation→
- LOS→