The Role of E-health in COPD Monitoring: A Narrative Review for a New Perspective

Öz

Background: With the growing number of COPD patients, there is pressure on the quality, accessibility, and affordability of care. Telemedicine approaches, such as tele-monitoring and tele-education, can be effective in initiating an increase in treatment, when necessary, with feedback to healthcare providers about changes in clinical conditions. Tele-monitoring can also facilitate early diagnosis and treatment of accompanying co-morbid exacerbations, resulting in a decrease in the number of emergency room visits and hospital admissions. Digital tools have been shown to effectively support exercise programs in COPD, with positive perceptions and experiences among participants. Methods: This review focuses on the potential benefits of using eHealth applications in the care of patients with chronic obstructive pulmonary disease (COPD). Results: The review emphasizes the potential benefits of eHealth applications for the care of patients with COPD. Conclusion: The COVID-19 pandemic has highlighted the importance of remote monitoring and effective self-management for patients with COPD. E-health tools can provide better care, especially for patients who are geographically or socially isolated, patients with time conflicts, or patients who cannot go to regular physician visits due to comorbid diseases. However, there is a need for larger-scale trials of self-management interventions delivered by tele-health, based on explicit self-management theory, linked with an evaluation that includes detailed descriptions of the intervention and the process delivery, intermediate outcomes such as self-efficacy and specific behavior changes, to gain more insight into the optimal combination of in-person care and eHealth-based self-management. To maximize the effectiveness of these tools, further research is needed to assess patient preferences, identify the best platform for patients that is easy to use and evaluating related costs. Pre-defined tags in self-management at a distance are also necessary to continue to evolve and innovate

Anahtar Kelimeler

• COPD
• E-health
• Remote monitoring
• Chronic respiratory disease
• Telemedicine

E-sağlığın KOAH (Kronik Obstrüktif Akciğer Hastalığı) İzlemindeki Rolü: Yeni Bir Bakış Açısı İçin Anlatısal Bir İnceleme

Öz

Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) hastalarının sayısı artarken, bakım kalitesi, erişilebilirliği ve uygunluğu üzerinde baskılar oluşmaktadır. Tele-takip ve tele-eğitim gibi tele-tıp yaklaşımları, gerektiğinde tedaviyi takip konusunda etkili olabilir ve klinik durumda değişiklikler hakkında sağlık hizmeti sağlayıcılarına geri bildirim sağlayabilir. Aynı zamanda tele-takip, eşlik eden komorbid alevlenmelerin erken teşhis ve tedavisini kolaylaştırabilir, bu da acil servis ziyaretlerinin ve hastane yatışlarının sayısını azaltabilir. Dijital araçlar, KOAH hastalarının egzersiz programlarını etkili bir şekilde destekleyebilir ve katılımcılar arasında olumlu algılar ve deneyimler ortaya çıkarmıştır. Yöntemler: Bu inceleme, KOAH hastalarının bakımında e-sağlık uygulamalarının faydalarına odaklanmaktadır. Bulgular: İnceleme, KOAH hastalarının bakımı için e-sağlık uygulamalarının olası faydalarını vurgulamaktadır. Sonuç: COVID-19 pandemisi, KOAH hastaları için uzaktan izleme ve etkili kendi kendine yönetimin önemini vurgulamıştır. E-sağlık araçları, coğrafi veya sosyal izolasyon içinde bulunan, zaman çatışması yaşayan veya komorbid hastalıklar nedeniyle düzenli doktor ziyaretlerine gidemeyen hastalar için daha iyi bir bakım sağlayabilir.

Anahtar Kelimeler

• KOAH
• E-sağlık
• Uzaktan izleme
• Teletıp
• Kronik solunum hastalığı

Kaynakça

1. 1. Ministerio de Sanidad y Polıtica Social. Estrategia en EPOC del Sistema Nacional de Salud. Ministry of Health and Social Policy. COPD Strategy of the National Health System. Spain. Madrid; 2009.
2. 2. Baraldo S, Turato G, Saetta M. Pathophysiology of the small airways in chronic obstructive pulmonary disease. Respiration, 2012,84(2), 89-97.
3. 3. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006; 27(2): 397-412.
4. 4. Lange P, Celli B, Agusti A, et al. Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease. N Engl J Med 2015; 373(2): 111-22.
5. 5. Tashkin DP, Altose MD, Bleecker ER, et al. The lung health study: airway responsiveness to inhaled methacholine in smokers with mild to moderate airflow limitation. The Lung Health Study Research Group. Am Rev Respir Dis 1992; 145(2 Pt 1): 301-10.
6. 6. Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet 2009; 374(9691): 733-43.
7. 7. Agustí, A., Vogelmeier, C., & Faner, R. COPD 2020: changes and challenges. American Journal of Physiology-Lung Cellular and Molecular Physiology, 319(5), L879-L883.
8. 8. Carrasco Garrido P, de Miguel DJ, Rejas Gutiérrez J, Centeno AM, Gobartt Vázquez E, Gil de Miguel A, García Carballo M, Jiménez García R. Negative impact of chronic obstructive pulmonary disease on the health-related quality of life of patients. Results of the EPIDEPOC study. Health Qual Life Outcomes. 2006;4:31.

9. 9. Anzueto A. Impact of exacerbations on COPD. Eur Respir Rev. 2010;19(116):113–8.
10. 10. Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW, Bandura A, et al. Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care 2001 Nov;39(11):1217-1223.
11. 11. Yiğitbaş, B. 1. Sınırlar KOAH’ta Teletıp Hizmetinin Çerçeveleri. TÜSAD, 29.
12. 12. World Health Organization (WHO). Digital Health. https://www.who.int/health-topics/digital-health#tab=tab_1. (accessed September 17, 2023)
13. 13. Eskici, V., & Toraman, R. L. (2022). E-Sağlık Uygulamaları. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi, 3(3), 25-31.
14. 14. Lisa M, Koonin B.H, Clarisse A, Leroy T.Z, Farris K, et al. Harris. Trends in the Use of Telehealth during the Emergence of the COVID-19 Pandemic-United States, January–March 2020; US Department of Health and Human Services/Centers for Disease Control and Prevention: Atlanta, GA, USA, 2020; Volume 69, pp. 1595–1599.
15. 15. Bourbeau J, Julien M, Maltais F, Rouleau M, Beaupré A, et al. Chronic Obstructive Pulmonary Disease axis of the Respiratory Network Fonds de la Recherche en Santé du Québec. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med 2003 Mar 10;163(5):585-591.
16. 16. Thoolen B, De Ridder D, Bensing J, Maas C, Griffin S, et al. Effectiveness of a self-management intervention in patients with screen-detected type 2 diabetes. Diabetes Care 2007 Nov;30(11):2832-2837. doi: 10.2337/dc07-0777.
17. 17. Ambrosino N, Fracchia C. The role of tele-medicine in patients with respiratory diseases. Expert Rev Respir Med. 2017;11(11): 893–900. DOI:10.1080/17476348.2017.1383898
18. 18. O’Connor S, Hanlon P, O’Donnell C. A. et al. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies,2016, BMC Med. Inf. Decis. Mak. 16, 120.
19. 19. Andersson J, Bäck J. The Swedish Internet Foundation; 2020. https://svenskarnaochinternet.se/rapporter/ svenskarna-och-internet-2020/fakta-om-svenskarna-och-internet-2020/. (accessed September 17, 2023)
20. 20. Finkelstein J, Friedman RH. Potential role of telecommunication technologies in the management of chronic health conditions. Disease Management and Health Outcomes 2000;8(2):57-63. [doi: 10.2165/00115677-200008020-00001]
21. 21. Kruis AL, van Schayck OC, in't Veen JC, van der Molen T, Chavannes NH. Successful patient self-management of COPD requires hands-on guidance. Lancet Respir Med 2013 Nov;1(9):670-672. [doi: 10.1016/S2213-2600(13)70212-1]
22. 22. Uribe-Toril J, Ruiz-Real J.L, Nievas-Soriano B.J. A Study of eHealth from the Perspective of Social Sciences. Healthcare 2021, 9, 108. [CrossRef]
23. 23. Çoban, M. (2023). Türkiye’de E-Sağlık Uygulamalarında Mevcut Durum. Bingöl Üniversitesi Sağlık Dergisi, 4(1), 197-204.
24. 24. Wu J, Chang L, Yu G. Effective Data Decision-Making And Transmission System Based On Mobile Health For Chronic Disease Management In The Elderly. IEEE Syst. J. 2020, 1–12.
25. 25. Odei-Lartey E, Prah R, Anane E, Danwonno H, Gyaase S, et al. Utilization Of The National Cluster Of District Health Information System For Health Service Decision-Making At The District, Sub-District And Community Levels In Selected Districts Of The Brong Ahafo Region In Ghana. BMC Health Serv. Res. 2020, 20, 514.
26. 26. Sönnerfors, Pernilla, et al. "Access to, use, knowledge, and preferences for information technology and technical equipment among people with chronic obstructive pulmonary disease (COPD) in Sweden. A cross-sectional survey study." BMC Medical Informatics and Decision Making 21.1 (2021): 1-10.
27. 27. Kocabaş A, Atış S, Çöplü L, Erdinç E, Ergan B, et al. Kronik obstrüktif akciğer hastaliği (KOAH) koruma, tani ve tedavi raporu 2014. Official journal of the Turkish Thoracic Society, 15(2), 1-72.
28. 28. Spruit MA, Singh SJ, Garvey C, et al; ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64. doi: 10.1164/rccm.201309-1634ST.
29. 29. Lindenauer PK, Stefan MS, Pekow PS, et al. Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries. JAMA. 2020 May 12;323(18):1813-1823. doi: 10.1001/jama.2020.4437.
30. 30. Liu S, Zhao Q, Li W, et al. The Cost-Effectiveness of Pulmonary Rehabilitation for COPD in Different Settings: A Systematic Review. Appl Health Econ Health Policy. 2021 May;19(3):313-324. doi: 10.1007/s40258-020-00613-5.
31. 31. Yakutcan U, Demir E, Hurst JR, et al. Operational Modeling with Health Economics to Support Decision Making for COPD Patients. Health Serv Res. 2021 Dec;56(6):1271-1280. doi:10.1111/1475-6773.13652.
32. 32. Kong C. W. & Wilkinson T. M. A. Predicting and preventing hospital readmission for exacerbations of COPD, 2020, ERJ Open Res. 6, 00325–02019.
33. 33. Ram FS, Wedzicha JA, Wright J, Greenstone M. Hospital at home for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2003;4:CD003573.
34. 34. Donner CF, ZuWallack R, Nici L. The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease. Medicina. 2021; 57(7):726. https://doi.org/10.3390/medicina57070726 (accessed September 17, 2023)
35. 35. Nici L, ZuWallack R. Integrated Care in Chronic Obstructive Pulmonary Disease and Rehabilitation. COPD: J. Chronic Obstr. Pulm. Dis. 2018, 15, 223–230.
36. 36. Elbert NJ, van Os-Medendorp H, van Renselaar W, et al. Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: a systematic review of systematic reviews and meta-analyses. J Med Internet Res. 2014;16(4). doi:10.2196/jmir.2790
37. 37. Lorig KR, Ritter PL, Laurent DD, Plant K. Internet-based chronic disease self-management: a randomized trial. Med Care. 2006;44:964–971.
38. 38. Barbosa MT, Sousa CS, Morais-Almeida M, et al. Telemedicine in COPD: An Overview by Topics. COPD. 2020 Oct;17(5):601-617. doi: 10.1080/15412555.2020.1815182.
39. 39. Kermelly, Sophie B, Bourbeau J. "eHealth in Self-Managing at a Distance Patients with COPD, 2022, Life 12.6 : 773.
40. 40. Tomasic I, Tomasic N, Trobec R, Krpan M, Kelava T. Continuous remote monitoring of COPD patients-justification and explanation of the requirements and a survey of the available technologies. Med Biol Eng Comput. 2018 Apr;56(4):547-569. doi: 10.1007/s11517-018-1798z.
41. 41. Rashkovska A, Tomašić I, Bregar K, Trobec R ,Remote monitoring of vital functions—proof-of-concept system, 2012, In:Proc. 35th Int. conv. MIPRO. pp 446–450.
42. 42. Trobec R, Tomašić I, Synthesis of the 12-lead electrocardiogram from differential leads, 2011, IEEE Trans Inf Technol Biomed 15:615–621. https://doi.org/10.1109/TITB.2011.2159236
43. 43. Cruz J, Brooks D, Marques A, Home telemonitoring in COPD: a systematic review of methodologies and patients’ adherence, 2014, Int J Med Inform 83:249–263. https://doi.org/10.1016/j.ijmedinf.2014.01.008
44. 44. Aaron SD, Donaldson GC, Whitmore GA, et al. Time course and pattern of COPD exacerbation onset. Thorax. 2012 Mar;67(3):238-43. doi: 10.1136/thoraxjnl-2011-200768.
45. 45. Goto T, Faridi MK, Gibo K, et al. Trends in 30-day readmission rates after COPD hospitalization, 2006-2012. Respir Med. 2017 Sep;130: 92-97. doi: 10.1016/j.rmed.2017.07.058.
46. 46. McLean S, Nurmatov U, Liu JL, Pagliari C, Car J, et al. Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis. Br J Gen Pract. 2012;62(604):e739–e749. doi:10.3399/bjgp12X658269
47. 47. Lundell S, Holmner Å, Rehn B, Nyberg A, Wadell K. Telehealthcare in COPD: a systematic review and meta-analysis on physical outcomes and dyspnea. Respir Med. 2015;109(1):11.26.
48. 48. Işik, A. H., Güler, I., & Sener, M. U. (2013). A low-cost mobile adaptive tracking system for chronic pulmonary patients in home environment. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 19(1), 24–30.
49. 49. Chan C, Yamabayashi C, Syed N, Kirkham A. & Camp P. G. Exercise tele-monitoring and telerehabilitation compared with traditional cardiac and pulmonary rehabilitation: a systematic review and meta-analysis. 2016, Physiotherapie Can. 68, 242–51.
50. 50. Moy M. L, Collins R.J, Martinez C. H, Kadri R, Roman P. et al. An internet-mediated pedometer-based program improves health-related quality-of-life domains and daily step counts in COPD: a randomized controlled trial, 2015, Chest 148, 128–37.
51. 51. Nguyen H. Q, Gill D. P, Wolpin S, Steele B. G, Benditt M, J. O. Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD, 2019, Int.J. Chronic Obstr. Pulm. Dis. 4, 301–13.
52. 52. Rassouli F, Boutellier D, Duss J, Huber S & Brutsche M.H. Digitalizing multi-disciplinary pulmonary rehabilitation in COPD with a smartphone application: an international observational pilot study, 2018, Int J. Chron. Obstruct Pulmon Dis. 13, 3831–3836.