Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Ontario, Canada.
J Telemed Telecare. 2010;16(3):120-7. doi: 10.1258/jtt.2009.090812. Epub 2010 Mar 2.
We conducted a systematic review of the literature about home telehealth for chronic obstructive pulmonary disease (COPD) compared with usual care. An electronic literature search identified 6241 citations. From these, nine original studies (10 references) relating to 858 patients were selected for inclusion in the review. Four studies compared home telemonitoring with usual care, and six randomized controlled trials compared telephone support with usual care. Clinical heterogeneity was present in many of the outcomes measured. Home telehealth (home telemonitoring and telephone support) was found to reduce rates of hospitalization and emergency department visits, while findings for hospital bed days of care varied between studies. However, the mortality rate was greater in the telephone-support group compared with usual care (risk ratio = 1.21; 95% CI: 0.84 to 1.75). Home telehealth interventions were similar or better than usual care for quality of life and patient satisfaction outcomes.
我们对家庭远程医疗治疗慢性阻塞性肺疾病(COPD)与常规护理的疗效进行了系统评价。电子文献检索确定了 6241 条引文。从中选择了 9 项原始研究(10 篇参考文献),涉及 858 名患者,纳入本综述。四项研究比较了家庭远程监测与常规护理,六项随机对照试验比较了电话支持与常规护理。许多测量的结果存在临床异质性。家庭远程医疗(家庭远程监测和电话支持)可降低住院率和急诊就诊率,而研究之间的住院天数差异不同。然而,与常规护理相比,电话支持组的死亡率更高(风险比=1.21;95%置信区间:0.84 至 1.75)。家庭远程医疗干预在生活质量和患者满意度方面与常规护理相似或更好。