Gaveikaite Violeta, Fischer Claudia, Schonenberg Helen, Pauws Steffen, Kitsiou Spyros, Chouvarda Ioanna, Maglaveras Nicos, Roca Josep
Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Research, Philips Electronics Nederland B.V., Eindhoven, Netherlands.
BMJ Open. 2018 Sep 19;8(9):e021865. doi: 10.1136/bmjopen-2018-021865.
Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease characterised by persistent respiratory symptoms. A focus of COPD interventional studies is directed towards prevention of exacerbations leading to hospital readmissions. Telehealth as a method of remote patient monitoring and care delivery may be implemented to reduce hospital readmissions and improve self-management of disease. Prior reviews have not systematically assessed the efficacies of various telehealth functionalities in patients with COPD at different stages of disease severity. We aim to evaluate which COPD telehealth interventions, classified by their functionalities, are most effective in improving patient with COPD management measured by both clinical and resource utilisation outcomes.
We will conduct a systematic review which will include randomised controlled trials comparing the efficacy of telehealth interventions versus standard care in patients with COPD with confirmed disease severity based on forced expiratory volume(%) levels. An electronic search strategy will be used to identify trials published since 2000 in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINHAL. Telehealth is described as remote monitoring and delivery of care where patient data/clinical information is routinely or continuously collected and/or processed, presented to the patient and transferred to a clinical care institution for feedback, triage and intervention by a clinical specialist. Two authors will independently screen articles for inclusion, assess risk of bias and extract data. We will merge studies into a meta-analysis if the interventions, technologies, participants and underlying clinical questions are homogeneous enough. We will use a random-effects model, as we expect some heterogeneity between interventions. In cases where a meta-analysis is not possible, we will synthesise findings narratively. We will assess the quality of the evidence for the main outcomes using GRADE.
Research ethics approval is not required. The findings will be disseminated through publication in a peer-reviewed journal.
CRD42018083671.
慢性阻塞性肺疾病（COPD）是一种高度流行的慢性疾病，其特征为持续的呼吸道症状。COPD干预研究的一个重点是预防导致再次入院的病情加重。远程医疗作为一种远程患者监测和护理提供方法，可用于减少再次入院并改善疾病的自我管理。先前的综述尚未系统评估不同严重程度阶段的COPD患者中各种远程医疗功能的疗效。我们旨在评估按功能分类的哪些COPD远程医疗干预措施在改善COPD患者管理方面最有效，这通过临床和资源利用结果来衡量。
我们将进行一项系统综述，其中将包括随机对照试验，比较远程医疗干预措施与标准护理在基于用力呼气量（%）水平确诊疾病严重程度的COPD患者中的疗效。将使用电子检索策略来识别2000年以来在MEDLINE、EMBASE、Cochrane对照试验中央注册库、CINHAL上发表的试验。远程医疗被描述为远程监测和护理提供，其中患者数据/临床信息被常规或连续收集和/或处理，呈现给患者并传输到临床护理机构，以供临床专家进行反馈、分诊和干预。两位作者将独立筛选文章以纳入研究，评估偏倚风险并提取数据。如果干预措施、技术、参与者和潜在临床问题足够同质，我们将把研究合并进行荟萃分析。由于我们预计干预措施之间存在一些异质性，因此将使用随机效应模型。在无法进行荟萃分析的情况下 ，我们将以叙述方式综合研究结果。我们将使用GRADE评估主要结果的证据质量。
无需研究伦理批准。研究结果将通过在同行评审期刊上发表进行传播。
PROSPERO注册号：CRD42018083671。
