Telemedical Interventions for Chronic Obstructive Pulmonary Disease Management: Umbrella Review

• Published in: Journal of medical Internet research Vol. 25; no. 9859; p. e33185
• Main Authors: Koh, Jin Hean, Chong, Lydia Ching Yee, Koh, Gerald Choon Huat, Tyagi, Shilpa
• Format: Journal Article
• Language: English
• Published: Canada Journal of Medical Internet Research 16.02.2023; Gunther Eysenbach MD MPH, Associate Professor; JMIR Publications
• Subjects: Analysis; Chronic obstructive pulmonary disease; Clinical outcomes; Delivery of Health Care; Disease management; Dropping out; Epidemics; Exercise; Health care; Hospitalization; Humans; Inpatient care; Intervention; Lung diseases, Obstructive; Monasteries; Physical activity; Physical fitness; Pulmonary Disease, Chronic Obstructive - therapy; Quality of Life; Rehabilitation; Review; Systematic review; Systematic Reviews as Topic; Telemedicine; Telemedicine - methods; Australia; United States > US; telemedicine; telehealth; chronic obstructive pulmonary disease
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/33185

Chronic obstructive pulmonary disease (COPD) is a growing epidemic, with a heavy associated economic burden. Education, physical activity, and pulmonary rehabilitation programs are important aspects of the management of COPD. These interventions are commonly delivered remotely as part of telemedicine interventions. Several systematic reviews and meta-analyses have been conducted to assess the effectiveness of these interventions. However, these reviews often have conflicting conclusions. We aim to conduct an umbrella review to critically appraise and summarize the available evidence on telemedicine interventions for the management of COPD. In this umbrella review, the MEDLINE, Embase, PsycINFO, and Cochrane databases were searched from inception to May 2022 for systematic reviews and meta-analyses relating to telemedicine interventions for the management of COPD. We compared odds ratios, measures of quality, and heterogeneity across different outcomes. We identified 7 systematic reviews that met the inclusion criteria. Telemedicine interventions used in these reviews were teletreatment, telemonitoring, and telesupport. Telesupport interventions significantly reduced the number of inpatient days and quality of life. Telemonitoring interventions were associated with significant reductions in respiratory exacerbations and hospitalization rates. Teletreatment showed significant effectiveness in reducing respiratory exacerbations, hospitalization rate, compliance (acceptance and dropout rate), and physical activity. Among studies that used integrated telemedicine interventions, there was a significant improvement in physical activity. Telemedicine interventions showed noninferiority or superiority over the standard of care for the management of COPD. Telemedicine interventions should be considered as a supplement to usual methods of care for the outpatient management of COPD, with the aim of reducing the burden on health care systems.