University of Illinois Chicago, Chicago, Illinois, USA.
Curr Opin Pulm Med. 2022 Mar 1;28(2):93-98. doi: 10.1097/MCP.0000000000000851.
Many healthcare systems rapidly implemented telehealth as a substitute for in-person care during the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this review is to describe the evidence base supporting the use of telehealth for chronic obstructive pulmonary disease (COPD) prior to the COVID-19 pandemic, discuss the barriers to implementing telehealth during the pandemic, and share our opinion about the future of telehealth in COPD.
The evidence from randomized clinical trials in COPD completed prior to the COVID-19 pandemic indicate that the effectiveness of telehealth interventions compared to in-person usual care on clinical outcomes is inconclusive. Recent experience during the COVID-19 pandemic indicates that telehealth may increase access to healthcare and satisfaction with care when delivered in addition to usual in-person care. While some reimbursement-related barriers to telehealth have been alleviated during the COVID-19 pandemic, several patient, provider, and health-system barriers to implementation remain.
There is a need to further evaluate the delivery of telehealth services as an adjunct to traditional in-person models of COPD care. Standardization and reporting of core clinical, satisfaction, accessibility, and quality of care outcomes are needed to promote cross-study learning and more rapid translation of research evidence into practice.
目的综述：许多医疗保健系统在 2019 年冠状病毒病（COVID-19）大流行期间迅速将远程医疗作为替代当面护理的手段。本文的目的是描述在 COVID-19 大流行之前，支持将远程医疗用于慢性阻塞性肺疾病（COPD）的证据基础，讨论在大流行期间实施远程医疗的障碍，并分享我们对 COPD 中远程医疗未来的看法。
最近发现：在 COVID-19 大流行之前完成的 COPD 随机临床试验的证据表明，远程医疗干预与当面常规护理相比在临床结局方面的有效性尚无定论。COVID-19 大流行期间的最新经验表明，远程医疗在常规当面护理之外，可能会增加获得医疗保健的机会并提高患者对护理的满意度。虽然在 COVID-19 大流行期间，一些与报销相关的远程医疗障碍已经得到缓解，但仍存在一些患者、提供者和医疗系统实施方面的障碍。
总结：需要进一步评估远程医疗服务作为 COPD 传统当面护理模式的辅助手段的提供情况。需要对核心临床、满意度、可及性和护理质量结果进行标准化和报告，以促进跨研究学习，并更快速地将研究证据转化为实践。
