Table 3.

Methodology and Findings Pertaining to Chronic Obstructive Pulmonary Disease

LITERATURE SOURCE			METHODOLOGY				FINDINGS
REFERENCE	DATE	COUNTRY	DESIGN	SIZE (N)	DURATION	TELEMEDICINE TECHNOLOGY	FEASIBILITY AND RELIABILITY	USE OF SERVICE	HEALTH OUTCOMES	COMMENTS
Raza et al.115	2009	United States	RCC/PCC	314	7 years	VTC	Yes	8% required in-person visits	NM	Patient travel avoided; patient satisfied
Bonavia et al.116	2009	Italy	OS	937	2 years	TS via T	Yes	NM	O	High GP acceptance of TS
Averame et al.117	2009	Italy	OS/PCC	638	NR	TS via T	Yes	NM	TS used in diagnosis and airway management	Encourages testing of smokers without symptoms
Bernocchi et al.118	2012	Italy	OS	474	6/12 months	T, POx	Yes	NM	HPS	Growing need for home management
Whitten and Mickus119	2007	United States	RCT	161	11 weeks	VTC	Yes	NM	HPS	Small n
Vitacca et al.120	2009	Italy	RCT	240	1 year	T, POx	Yes	−36% hospitalizations; −65% GP calls	−71% acute exacerbations; telemedicine greater care advantage	Overall costs 33% less with telemedicine
Vitacca et al.121	2010	Italy	OS	396	5 years	NC, POx	Yes	Nurse time increased; MD time decreased	—	39% cost savings
Dinesen et al.122	2012	Denmark	RCT	111	10 months	WTM, VTC	Yes	Lower hospitalization	—	Small sample size
Sorknaes et al.123	2013	Denmark	RCT	266	26 weeks	VTC	Yes	O	1 week of teleconsultations post-AECOPD, no effect	Patients had ECOPD; only 1 week of telesupport
Sorknaes et al.124	2011	Denmark	NRCT	100	28 days	VTC	Yes	NM	HPS	VTC showed protective factor
Pinnock et al.125	2013	United States	RCT	256	12 months	HTM	Yes	Not effective with ECOPD	O	Speculates positive results of other studies due to clinical service
Strickland et al.126	2011	Canada	CNRA	409	6 months	VTC	Yes	Reduced and delayed re-admisions/LOS	QoL up	Lower re-admission rate (12% versus 22%)
de Toledo et al.127	2006	Spain	RCT	157	1 year	Call center,Web, HTM, VTC	Yes	Lower number of re-admissions	—	Value in integrated telemedicine case management
Gellis et al.128	2012	United States	RCT	102	12 months	T, HTM	Yes	—	Health, social functioning, depression, ER visits all improved	LOS not significant at 12 months
Pedone et al.129	2013	Italy	RCT	100	9 months	POx, T, wristband vitals monitor	Yes	LOS longer for intervention group	Med use, hospitalization, exacerbation risk all lower	Vitals collected every 3 hours
Cardozo and Steinberg130	2010	United States	OS	851	60 days	HTM (embedded in EMR)	Yes	Positive telemedicine benefit for hospitalization, ER visits	Improved survival	Re-hospitalization rate 13.9% and ER visits 29% (versus national rates of 56.4% and 45%, respectively)
Thijssing et al.131	2013	The Netherlands	OS	1,958	3.5 years	TS	Yes	Physical referrals reduced 27%	TPC increased pulmonologists' referrals 18% where needed	Unneeded referrals reduced 68%

AECOPD, acute exacerbated chronic obstructive pulmonary disease; CNRA, comparative nonrandomized analysis; ECOPD, exacerbated chronic obstructive pulmonary disease; EMR, electronic medical record; ER, emergency room; GP, general practitioner; HPS, high patient satisfaction; HTM, home telemonitoring; LOS, length of stay; NM, not measured; NR, not reported; NRCT, nonrandomized controlled trial; O, neutral outcome; OS, observational study; PCC, prospective case control; POx, pulse oximeter; QoL, quality of life; RCC, retrospective case control; T, telephone; TPC, telepulmonary consultations; TS, telespirometry; VTC, video teleconference; WTM, wireless telemonitoring.