Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Occupational Therapy, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands.
J Telemed Telecare. 2024 Aug;30(7):1097-1115. doi: 10.1177/1357633X221122124. Epub 2022 Aug 31.
Telemonitoring and telerehabilitation can support home-based pulmonary rehabilitation (PR) and benefit patients with lung diseases or COVID-19. This study aimed to (1) identify which telemonitoring and telerehabilitation interventions (e.g. videoconferencing) are used to provide telehealth care for people with chronic respiratory conditions or COVID-19, and (2) provide an overview of the effects of telemonitoring and telerehabilitation on exercise capacity, physical activity, health-related QoL (HRQoL), and healthcare use in patients with lung diseases or COVID-19.
A search was performed in the electronic databases of Ovid MEDLINE, EMBASE, and Cinahl through 15 June 2021. Subject heading and keywords were used to reflect the concepts of telemonitoring, telerehabilitation, chronic lung diseases, and COVID-19. Studies that explored the effect of a telerehabilitation and/or telemonitoring intervention, in patients with a chronic lung disease such as asthma, chronic obstructive pulmonary diseases (COPD), or COVID-19, and reported the effect of the intervention in one or more of our outcomes of interest were included. Excluding criteria included evaluation of new technological components, teleconsultation or one-time patient assessment.
This scoping review included 44 publications reporting the effect of telemonitoring (25 studies), telerehabilitation (8 studies) or both (11 studies) on patients with COPD (35 studies), asthma (5 studies), COPD and asthma (1 study), and COVID-19 (2 studies). Patients who received telemonitoring and/or telerehabilitation had improvements in exercise capacity in 9 out of 11 (82%) articles, better HRQoL in 21 out of 25 (84%), and fewer health care use in 3 out of 3 (100%) articles compared to pre-intervention. Compared to controls, no statistically significant differences were found in the intervention groups' exercise capacity in 5 out 6 (83%) articles, physical activity in 3 out of 3 (100%) articles, HRQoL in 21 out of 25 (84%) articles, and healthcare use in 15 out of 20 (75%) articles. The main limitation of the study was the high variability between the characteristics of the studies, such as the number and age of the patients, the outcome measures, the duration of the intervention, the technological components involved, and the additional elements included in the interventions that may influence the generalization of the results.
Telemonitoring and telerehabilitation interventions had a positive effect on patient outcomes and appeared to be as effective as standard care. Therefore, they are promising alternatives to support remote home-based rehabilitation in patients with chronic lung diseases or COVID-19.
远程监测和远程康复可以为居家肺康复提供支持，并有益于患有肺部疾病或 COVID-19 的患者。本研究旨在：(1) 确定用于为慢性呼吸系统疾病或 COVID-19 患者提供远程医疗服务的远程监测和远程康复干预措施（例如视频会议）；(2) 概述远程监测和远程康复对患有肺部疾病或 COVID-19 的患者的运动能力、身体活动、健康相关生活质量（HRQoL）和医疗保健使用的影响。
通过 2021 年 6 月 15 日在 Ovid MEDLINE、EMBASE 和 Cinahl 电子数据库中进行检索，使用主题词和关键词反映远程监测、远程康复、慢性肺部疾病和 COVID-19 的概念。纳入的研究探讨了远程康复和/或远程监测干预对哮喘、慢性阻塞性肺疾病（COPD）或 COVID-19 等慢性肺部疾病患者的影响，并报告了干预措施对我们感兴趣的一个或多个结果的影响。排除标准包括评估新技术组件、远程咨询或一次性患者评估。
本范围综述纳入了 44 篇报告远程监测（25 项研究）、远程康复（8 项研究）或两者（11 项研究）对 COPD（35 项研究）、哮喘（5 项研究）、COPD 和哮喘（1 项研究）和 COVID-19（2 项研究）患者影响的研究。与干预前相比，接受远程监测和/或远程康复的患者在 9 项研究中的 11 项（82%）中运动能力得到改善，在 21 项研究中的 25 项（84%）中 HRQoL 得到改善，在 3 项研究中的 3 项（100%）中医疗保健使用减少。与对照组相比，在 6 项研究中的 5 项（83%）中，干预组的运动能力，3 项研究中的 3 项（100%）中的身体活动，25 项研究中的 21 项（84%）中的 HRQoL，以及 20 项研究中的 15 项（75%）中的医疗保健使用均未发现统计学上的显著差异。研究的主要局限性是研究特征之间的高度变异性，例如患者的数量和年龄、结局测量、干预持续时间、所涉及的技术组件以及干预措施中包含的其他元素，这可能会影响结果的推广。
远程监测和远程康复干预措施对患者结局有积极影响，似乎与标准护理一样有效。因此，它们是为慢性肺部疾病或 COVID-19 患者提供远程居家康复的有前途的替代方法。
