Telemonitoring Parameters Used in Home-based Rehabilitation With COPD: A Systematic Review

Abstract

Background:

Telemonitoring (TM) with COPD patients has been shown to reduce hospitalization and exacerbations events. However, information about the most crucial parameters that constructed home-based rehabilitation programs still limited and conflicting. The objective was to summarize and report the most common TM parameters with COPD.

Methods:

A systematic search was performed up to April 2020 included MEDLINE (Ovid), CINAHL, Cochrane library, and Embase databases. The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) checklist tool was used to guide the selection process. Only randomized controlled trials (RCTs) that provided TM during home-based rehabilitation programs to individuals with COPD were included. Two independent reviewers retrieved titles, abstracts, full texts, and completed data extractions. TM parameters were extracted from the description of interventions found in the included studies. To summarize TM parameters, we used descriptive statistics as frequency and percentages.

Results:

Among 1,577 abstracts identified, 96 articles underwent full-text review, and 27 were eligible and included. Overall, TM parameters were variable within our included studies. The most commonly used TM parameters were oxygen saturation (21/27) 77% and heart rate (19/27) 70 %. Whereas the lowest frequent TM parameters were respiratory rate (5/27) 18% and weight (3/27) 11%. All included studies used at least two or more TM parameters to follow-up with COPD patients. Majority of included studies were transferred patient data to healthcare centers for health care professional review and feedback. The most common ways to deliver guidance and feedback were telephone calls and predesigned online platforms (21/27) 77% and (14/27) 51%, respectively. Daily-bases TM was reported more than weekly-bases TM among all included studies (25/27) 92% versus (2/27) 7%. Daily score of symptoms and medication diaries were only the subjective parameters included in TM packages.

Conclusions:

Cardiorespiratory parameters are essential components of TM with COPD, but attention should be paid to further parameters such as cough and sputum production. The current review suggests optimizing the design of TM by considering more daily cardiorespiratory parameters to reflect patient status. Further research is needed to evaluate if using more TM parameters with COPD will increase the positive impact of home-based rehabilitation interventions.