Tabak Monique, Brusse-Keizer Marjolein, van der Valk Paul, Hermens Hermie, Vollenbroek-Hutten Miriam
Telemedicine Group, Roessingh Research and Development, Enschede, the Netherlands ; Telemedicine Group, University of Twente, Enschede, the Netherlands.
Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
Int J Chron Obstruct Pulmon Dis. 2014 Sep 9;9:935-44. doi: 10.2147/COPD.S60179. eCollection 2014.
The objective of this pilot study was to investigate the use of and satisfaction with a chronic obstructive pulmonary disease (COPD) telehealth program applied in both primary and secondary care. The program consisted of four modules: 1) activity coach for ambulant activity monitoring and real-time coaching of daily activity behavior, 2) web-based exercise program for home exercising, 3) self-management of COPD exacerbations via a triage diary on the web portal, including self-treatment of exacerbations, and 4) teleconsultation. Twenty-nine COPD patients were randomly assigned to either the intervention group (telehealth program for 9 months) or the control group (usual care). Page hits on the web portal showed the use of the program, and the Client Satisfaction Questionnaire showed satisfaction with received care. The telehealth program with decision support showed good satisfaction (mean 26.4, maximum score 32). The program was accessed on 86% of the treatment days, especially the diary. Patient adherence with the exercise scheme was low (21%). Health care providers seem to play an important role in patients' adherence to telehealth in usual care. Future research should focus on full-scale implementation in daily care and investigating technological advances, like gaming, to increase adherence.
这项初步研究的目的是调查在初级和二级护理中应用的慢性阻塞性肺疾病（COPD）远程医疗项目的使用情况和满意度。该项目包括四个模块：1）活动教练，用于监测步行活动并对日常活动行为进行实时指导；2）基于网络的家庭锻炼项目；3）通过网络门户上的分诊日记对COPD急性加重进行自我管理，包括急性加重的自我治疗；4）远程会诊。29名COPD患者被随机分为干预组（接受9个月的远程医疗项目）或对照组（常规护理）。网络门户上的页面点击量显示了该项目的使用情况，客户满意度调查问卷显示了对所接受护理的满意度。具有决策支持功能的远程医疗项目显示出较高的满意度（平均26.4分，满分32分）。在86%的治疗日可以访问该项目，尤其是日记模块。患者对锻炼计划的依从性较低（21%）。在常规护理中，医疗保健提供者似乎在患者对远程医疗的依从性方面起着重要作用。未来的研究应侧重于在日常护理中全面实施，并研究如游戏等技术进步以提高依从性。
