International Journal of COPD (Mar 2020)
The Health Diary Telemonitoring and Hospital-Based Home Care Improve Quality of Life Among Elderly Multimorbid COPD and Chronic Heart Failure Subjects
Abstract
Hans Lennart Persson,1,2 Johan Lyth,3,4 Leili Lind5,6 1Department of Respiratory Medicine in Linköping, Linköping University, Linköping SE-581 85, Sweden; 2Department of Biomedical and Clinical Sciences, Linköping University, Linköping SE-581 85, Sweden; 3Research and Development Unit in Region Östergötland, Linköping University, Linköping SE-581 85, Sweden; 4Department of Health, Medicine and Caring Sciences, Linköping University, Linköping SE-581 85, Sweden; 5Department of Biomedical Engineering/Health Informatics, Linköping University, Linköping SE-581 85, Sweden; 6Digital Systems Division, Department of Industrial Systems, RISE Research Institutes of Sweden, Linköping University, Linköping, S-581 83, SwedenCorrespondence: Hans Lennart PerssonDepartment of Respiratory Medicine in Linköping, Linköping University, Linköping SE-581 85, SwedenTel +46 13 10 1033621Email [email protected]: Elderly, multimorbid patients with advanced chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF) exhibit poor health-related quality of life (HRQoL). Telemonitoring, based on digital pen technology, supported by hospital-based home care (HBHC) significantly reduces the number of hospitalizations. We hypothesized that the same intervention would prevent the deterioration of HRQoL that follows upon disease progression.Methods: Elderly computer-illiterate subjects with ≥ 2 hospitalizations the previous year were included. HRQoL was assessed at inclusion (baseline) and at 1, 6 and 12 months employing EuroQol-5 Dimensions (EQ-5D) and RAND-36 for general HRQoL, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) and St. Georges Respiratory Questionnaire (SGRQ) for disease-specific HRQoL. Healthcare contacts, hospitalizations, as-needed medications, prescription changes and healthcare costs were registered.Results: Ninety-four patients were enrolled of which 53 subjects completed the 12-month study period. Compared to baseline, most domains of RAND-36 were improved significantly at 1 time-point or more. Only among COPD subjects, the disease-specific HRQoL was worsened at the 12 month evaluation. Measures of healthcare dependency were associated with poor HRQoL.Conclusion: The Health Diary system and HBHC together improve general HRQoL, and measures of healthcare dependency are associated with HRQoL variables.Keywords: digital pen, exacerbation, home care services, hospital-based, hospitalization, multimorbidity, telemedicine, QoL
