A telehealth program for self-management of COPD exacerbations and promotion of an active lifestyle: a pilot randomized controlled trial

Abstract

Monique Tabak,1,2 Marjolein Brusse-Keizer,3 Paul van der Valk,3,4 Hermie Hermens,1,2 Miriam Vollenbroek-Hutten1,2 1Telemedicine Group, Roessingh Research and Development, 2Telemedicine Group, University of Twente, 3Department of Pulmonary Medicine, Medisch Spectrum Twente, 4Medical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands Abstract: 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. Keywords: COPD, physical activity, exacerbations, telehealth, self-management