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Chronic obstructive pulmonary disease
Use, utility and methods of telehealth for patients with COPD in England and Wales: a healthcare provider survey
  1. Ahmed Al Rajeh1,2,
  2. Michael C Steiner3,
  3. Yousef Aldabayan1,2,
  4. Abdulelah Aldhahir1,4,
  5. Elisha Pickett1,
  6. Shumonta Quaderi1 and
  7. John R Hurst1
  1. 1 Respiratory Medicine, University College London Medical School, London, UK
  2. 2 Respiratory Care, King Faisal University, Al-Ahsa, Saudi Arabia
  3. 3 Respiratory, Institute for Lung Health, Leicester, UK
  4. 4 Respiratory Care, Jazan University, Jazan, Saudi Arabia
  1. Correspondence to Ahmed Al Rajeh; ahmed.rajeh.15{at}ucl.ac.uk

Abstract

Introduction Although the effectiveness of domiciliary monitoring (telehealth) to improve outcomes in chronic obstructive pulmonary disease (COPD) is controversial, it is being used in the National Health Service (NHS).

Aim To explore the use of teleheath for COPD across England and Wales, to assess the perceptions of clinicians employing telehealth in COPD and to summarise the techniques that have been used by healthcare providers to personalise alarm limits for patients with COPD enrolled in telehealth programmes.

Methods A cross-sectional survey consisting of 14 questions was sent to 230 COPD community services in England and Wales. Questions were designed to cover five aspects of telehealth in COPD: purpose of use, equipment type, clinician perceptions, variables monitored and personalisation of alarm limits.

Results 65 participants completed the survey from 52 different NHS Trusts. 46% of Trusts had used telehealth for COPD, and currently, 31% still provided telehealth services to patients with COPD. Telehealth is most commonly used for baseline monitoring and to allow early detection of exacerbations, with 54% believing it to be effective. The three most commonly monitored variables were oxygen saturation, heart rate and breathlessness. A variety of methods were used to set alarm limits with the majority of respondents believing that at least 40% of alarms were false.

Conclusion Around one-third of responded community COPD services are using telehealth, believing it to be effective without robust evidence, with a variety of variables monitored, a variety of hardware and varying techniques to set alarm limits with high false alarm frequencies.

  • chronic obstructive pulmonary disease
  • COPD
  • telehealth
  • home monitoring
  • alarm limits
  • perception

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2018-000345

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    Footnotes

    • Contributors AAR and JRH conceived and designed the study. Study questions were edited and revised by YA, AA, EP and SQ, while MCS facilitated the distribution of the survey. AAR and JRH performed the initial analysis, interpretation and evaluation of data. AAR wrote the first manuscript draft and all authors revised it for important intellectual content. All authors read and approved the final manuscript.

    • Funding King Faisal University through the Saudi Arabian Cultural Bureau in London.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval No Health Research Authority review, or Research and Development (R&D) approvals were required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement We will consider requests for data sharing via email to the corresponding author.