Using Telemedicine to Treat COPD
People with COPD who use technology to track their symptoms daily could get medical treatment for exacerbations before they become severe. See how telemedicine, still in its infancy, has potential for people with COPD.
By Madeline R. Vann, MPH
Medically Reviewed by Farrokh Sohrabi, MD
Don't Miss This
Sign Up for OurHealthy LivingNewsletter
Thanks for signing up!You might also like these other newsletters:
High-tech tools such as smartphone applications and videoconferencing offer the promise of more timely medical care and symptom management for people living with COPD. The trend toward using these technologies is growing, although researchers and physicians are still trying to understand how telemedicine can be used to deliver COPD care at home or provide needed COPD education to patients and families.
International studies have offered conflicting results, ranging from support for the potential of telemedicine to identify worsening symptoms early to statements that, given current systems, telemedicine is not a cost-effective tool for COPD care at home.
Telemedicine and COPD
Telehealth is a developing technology for COPD management. In an effort to understand how people with COPD fare in the winter, when exacerbations are more frequent, researchers developed a system for faxing daily symptom sheets between patients and project coordinators.
Although daily faxing was an effective way to monitor people’s daily symptoms in search of exacerbation signs, it was also cumbersome both for patients and the project staff, says the team's leader, COPD and asthma researcher Neil Johnston, MSc, an assistant professor in the division of respirology at McMaster University and an epidemiologist at the Firestone Institute for Respiratory Health in Ontario, Canada.
In a subsequent research project, Johnston and his team adapted BlackBerry smartphones for use by study participants to report their symptoms daily. The high-tech nature of the tools allowed the project coordinators to know more quickly whether an exacerbation was occurring.
“We had 99 percent compliance over 16 months with daily symptom provision, and we detected every single exacerbation at its inception,” says Johnston.
The results, published in the journal Chest, support the possible role for telehealth monitoring systems using smartphones.
One advantage to these tools, Johnston says, is that they can be preset to trigger alerts for patient and physician if certain symptoms are entered or if a day’s entry is skipped. The alerts would then spur the doctor’s office to check on the patient or order appropriate medications.
A similar study in Spain compared adults with heart failure or chronic lung disease who used personal digital assistants, or PDAs, to log a daily diary of symptoms and health measures such as heart rate with those who did not use PDAs. It found that daily remote monitoring of the symptoms reduced hospital admissions and length of stay. For every four patients who were monitored, the study found, one hospital admission could be avoided.
“Day after day we have more evidence of the usefulness of this technique,” says the study's lead researcher, Iñaki Martín-Lesende, on staff with the Comarca Bilbao Primary Healthcare District and the Basque Health Service in Spain. “Advantages include reducing the number and stay of hospital admissions, increasing patients’ quality of life, decreasing overload of careers, and reorganizing health systems.”
However, British researchers suggest that telemedicine, as it now stands, might not be cost-effective for health systems to implement. They reviewed health data and cost data for about a year from 965 adults with chronic diseases, including COPD; more than half of them used telehealth equipment and services in addition to usual care. When they compared those who were using the equipment with those who were continuing with usual care, they found that telemedicine was more costly because of the equipment costs.
Johnston says that people with COPD can face some significant barriers when using telemedicine. People with COPD tend to be older, easily fatigued, and often have other conditions that make using small screens and tiny fonts difficult.
“Good industrial engineering is important,” he says. In his BlackBerry-based study, at least one participant reported using a magnifying glass to be able to read the phone’s screen.
Where possible, good telehealth tools — whether for videoconferencing or sending files on a smartphone — will limit demands on energy and fine motor skills for people with COPD. For example, Johnston's team disabled the smartphones’ keyboards and taught the study participants to use the roller ball option to select their symptoms for their daily reports. Because the team included nurses who had extensive experience working with COPD patients, they were able to design telehealth tools that were easy for patients to use.
Martín-Lesende, drawing from his own experience in the Basque region of Spain, says that in order for telemedicine to work for COPD patients, health professionals will have to individualize care as much as possible even though some criteria will apply across the board; these include oxygen saturation, heart rate, dyspnea, cough, and deterioration.
He says that telemedicine programs will also have to:
But with the growth of high-tech tools to aid patients and physicians, telemedicine options such as COPD videoconferencing and smartphone tracking will probably expand and improve as well — making bigger inroads into COPD care at home.
Gourmet Coffee: Get the Perfect Cup atHome
How To Help Victims of the Pittsburgh Synagogue Shooting
How to Give Emotional Support
Julia Louis-Dreyfus: How She Broke the Seinfeld Curse
What is a supermoon
How to Put On Lotion
Calorie Definition and Why We Count Them
27 Breathtaking Watercolor Flower Tattoos
Elie Saab Wedding Dresses
Rule 7: Just because they look cute, doesn’t mean you can’t be creepy
Tag: Hairstyles with Bangs