Table 1.

Characteristics of studies (100+ patients for evaluation) investigating the effect of telehealth care interventions on quality of life in patients with COPD

Study	Type of study	No of patients	Types of telehealth intervention	Type of control	Mode of outcome measurement	Statistically significant group differences regarding QoL
McDowell et al9	Two-center, randomized controlled trial	110	Standardized home-based program + telemonitoring via home telehealth device Telemonitoring: daily clinical observations (blood pressure, heart rate, and oxygen saturation) and questions related to symptoms (difficulty in breathing, cough, sputum, and tiredness). Daily data reviewed within 10 minutes for signs of deterioration; if alert, contact to the patient. Also contact to the patient every week if no alerts.	Standardized home-based program Standard care: at least two home visits by physiotherapist and nurse for disease-specific education, including signs of exacerbation. Contact to respiratory team in case of exacerbation, and, if managed at home, close monitoring by the respiratory team. All patients offered rehabilitation or access to weekly maintenance exercise class.	SGRQ EuroQol-5D HADS	SGRQ (total and subscores), in favor of telehealth HADS (anxiety score), in favor of telehealth
Blumenthal et al3	Dual-site, randomized clinical trial	298	Cognitive-behavioral coping skills training Coping skills training: instruction in cognitive-behavioral coping skills to patients and partners over the telephone (14 sessions over 16 weeks). The program included four components: 1) education about stress and pulmonary health, 2) training in a variety of coping skills, 3) promotion of physical activity, and 4) maintenance and generalization.	Usual care and COPD education Usual care and COPD education: usual care through their local physician together with COPD education over the telephone (14 sessions).	Beck Depression Inventory-II State-Trait Anxiety Inventory-State SF-36 Pulmonary Quality of Life Scale UCSD Shortness of Breath Questionnaire Brief Fatigue Inventory SGRQ	“Psychological” QoL (anxiety, overall mental health, emotional role functioning, and social functioning), in favor of Telehealth “Somatic” QoL (fatigue and shortness of breath), in favor of telehealth
Pinnock et al10	Researcher-blinded, multicenter, randomized controlled trial	205	Usual clinical care + telemonitoring (touch screen) Telemonitoring: daily questionnaire about symptoms and use of treatment, self-assessment if symptoms had increased, symptoms of upper respiratory tract infection, or fever. Online data monitored daily and contact to patient if alert occurred.	Usual clinical care Usual clinical care: provided according to local service model, including education on self-management.	SGRQ HADS SECD6	None
Walters et al11	Cluster randomized controlled trial	154	Health mentoring Health mentoring: health mentor telephone calls (16 sessions of 30 minutes over 12 months) based on the following core components: 1) psychoeducation, 2) self-management skills training, 3) cognitive coping skills training, 4) communication skills, and 5) promotion of self-efficacy to manage chronic illness. Individualized action plans to reach goals were specified by participants in negotiation with the health mentor during phone calls.	Usual care Usual care: usual care provided by a GP plus regular monthly phone calls from a research nurse.	SF-36 SGRQ HADS	None
Stickland et al12	Parallel-group, noninferiority trial	135	Telehealth pulmonary rehabilitation via video link Telehealth pulmonary rehabilitation: video conference from their local hospital with a pulmonologist for assessment. Patients attended the telehealth pulmonary rehabilitation twice a week for 8 weeks within their local community. Program identical to standard pulmonary rehabilitation, although in smaller groups.	Standard pulmonary rehabilitation Standard pulmonary rehabilitation: two sessions per week for 8 weeks of group exercise for 2 hours and group education for 1 hour, supervised by a respiratory therapist.	–SGRQ	None
Trappenburg et al13	Multicenter, nonrandomized controlled study	115	Telemonitoring via home telehealth device + standard care Telemonitoring: daily personalized questionnaire that monitored their disease symptoms, medication compliance, and knowledge of their disease. Daily responses sent by patients were automatically categorized and prioritized (color coding). Telemonitoring was provided by respiratory nurses who reviewed patient answers Monday to Friday. In case of alarming values, the patients were contacted by the respiratory nurse.	Standard care Standard care: patients had usual access to their pulmonary physician, GP, and respiratory nurse.	CCQ	None

Abbreviations: QoL, quality of life; SGRQ, St George’s Respiratory Questionnaire; EuroQol-5D, EuroQol 5 Dimensions Questionnaire; HADS, Hospital Anxiety and Depression Scale; SF-36, Short Form 36; SECD6, Self-Efficacy for Managing Chronic Disease 6-Item Scale; GP, general practitioner; CCQ, Clinical COPD Questionnaire; UCSD, University of California, San Diego.