Table 1.
Main characteristics of the studies included.
| Author Year Country |
Type of study | Intervention Group (IG) Control Group (CG) |
Technology | >1 Monitoring devices involved (Yes/no) | Duration of the intervention | Disease | Intervention group | Control group | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of participants | Age mean years (SD) | Males N (%) | Number of participants | Age Mean years (SD) | Males N (%) | |||||||
| Telemonitoring | ||||||||||||
| Antoniades, Nick 2012 39 | RCT | IG: Remote In-home monitoring (TeleMedCare) + standard best practice. CG: Standard best practice |
Laptop (software), daily monitoring spirometry, vital functions, oximetry, etc. | Yes | 12 Months | COPD | 22 | 70 (10) | 10 (83) | 22 | 68 (9) | 10 (83) |
| Australia | ||||||||||||
| Au, David 2015 40 | Matched group design (1:1) | IG: Telehealth system combined with care management program (Health Buddy Program) CG: Matched to similar baseline characteristics |
Four button Health Buddy device; asks for vital signs, disease symptoms, provides feedback, and categorizes patient's medical risk. | No | 3 Years | COPD | 619 | 75 (8) | 338 (55) | 619 | 74 (10) | 338 (55) |
| USA | ||||||||||||
| Boer, Lonneke 2019 41 | RCT | IG: Smart mobile health tool for self-management (mHealth tool). CG: Paper action plan |
Mobile phone (app), collected information on symptom changes and physiological measurements using a pulse oximeter, spirometer, and forehead thermometer. | Yes | 12 Months | COPD | 43 | 69 (8) | 25 (58) | 44 | 65 (8) | 29 (66) |
| Netherlands | ||||||||||||
| Chan, Debora 2007 42 | RCT | IG: Internet-based home monitoring and education. CG: Office-based care |
Home computer (website), camera and internet access. Digital video camera to capture patient's performance. | No | 52 Weeks | Asthma | 60 | 10 (3) | 38 (63) | 60 | 9 (3) | 37 (62) |
| USA | ||||||||||||
| Chau, Janita 2012 43 |
RCT | IG: Telecare service (ASTRI) + nurse home visit (education) CG: Only nurse home visit (education) |
Mobile phone, respiratory rate sensor, pulse oximeter. Internet and wireless systems, databases and software for critical decision analysis, and support. | Yes | 2 Months | COPD | 22 | 73 (6) | 21 (95) | 22 | 72 (6) | 18 (82) |
| Hong Kong | ||||||||||||
| Cushen, Brenda 2021 44 |
Pre-post | GI: Community virtual ward model (patient information transferred to hospital portal) | Bluetooth-enabled smartphone and hospital portal. Remote monitoring of daily oxygen saturations, heart rate, and spirometry measurements. | Yes | Mean 10 (4) days admission to discharge | COPD and/or asthma | 20 | 64 (13) | 7 (35) | N/A | N/A | N/A |
| Ireland | ||||||||||||
| de Jongste, Johan 2009 45 |
RCT | GI: Daily telemonitoring of exhaled nitric oxide + monitoring symptoms CG: Symptoms monitoring only |
PalmOne, airway inflammation monitor (NIOX MINO; Aerocrine, Solna, Sweden) that measures FENO0.05 | No | 30 Weeks | Asthma | 77 | 11 (2) | 46 (60) | 74 | 11 (4) | 54 (73) |
| Netherlands | ||||||||||||
| Deng, Ning 2020 46 |
Pre-post | GI: Mobile health technology to deliver a community-based closed-loop management system (app) | MHealth system: smartphone (patient app), workstation (doctor), a cloud server, and a simple peak flow meter. | No | 6 Months | COPD | 39 | 61 (6) | 36 (92) | N/A | N/A | N/A |
| China | ||||||||||||
| Ding, Hang 2014 47 |
Pre-post | GI: A mobile-phone-based home monitoring system (app) | Mobile phone to record COPD symptoms and vital signs on portal. Thermometer, pulse oximeter. | Yes | 6 Months | COPD | 10 | 65 (9) | 5 (50) | N/A | N/A | N/A |
| Australia | ||||||||||||
| Farias, Raquel 2019 48 |
Pre-post | GI: Phone interactive telesystem (computer-linked interactive phone telesystem) | Card (PIN) and the Telesystem contact information with automated phone call questions and a callback notification. | No | 12 Months | COPD | 256 | 70 (9) | 117 (46) | N/A | N/A | N/A |
| Canada | ||||||||||||
| Farmer, Andrew 2017 49 | RCT | GI: Digital health system (EDGE, Self-management, anD support prorGrammE). CG: Standard care |
EDGE platform, tablet, and Bluetooth-enabled oximeter. | No | 12 Months | COPD | 110 | 69 (9) | 68 (62) | 56 | 69 (10) | 34 (61) |
| UK | ||||||||||||
| Jódar-Sánchez, Francisco 2013 50 |
RCT | IG: Home telehealth program (Tele-Modem, Aerotel Medical Systems) CG: Usual care. |
Spirometer, a pulse oximeter, heart rate, blood pressure monitor (model UA-767 BT, A&D Company). Data sent via a hub (Tele-Modem, Aerotel Medical Systems) connected to the patient's home telephone line. | Yes | 4 Months | COPD | 24 | 74 (8) | 23 (96) | 21 | 71 (10) | 20 (95) |
| Spain | ||||||||||||
| Koff, Patricia 2021 51 |
Quasi-randomized clinical trial | IG: Proactive iCare (healthcare delivery model that couples integrated care with remote monitoring) CG: Usual care |
Health buddy, finger pulse oximeter, handheld spirometer and pedometer. | Yes | 9 Months | COPD | 352 | 68 (8) | 205 (58) | 159 | 68 (9) | 106 (67) |
| USA | ||||||||||||
| Lewis, Keir E 2010 52 | RCT | IG: Home telemonitoring (telemonitoring via the home telephone line) + standard care CG: Standard care |
Handheld telemonitor connected via telephone line, thermometer, and pulse oximeter probe connected to the monitor. | Yes | 6 Months | COPD | 20 | 70 (range 61–73) | 10 (50) | 20 | 73 (range 63–79) | 10 (50) |
| UK | ||||||||||||
| McDowell, Janet 2015 53 |
RCT | IG: Home-based healthcare with telemonitoring (telecommunications device connected directly to patient's phone line) CG: Usual care |
Home telehealth system (HomMed, Honeywell, USA) self-monitoring to record vital signs (finger probe and blood cuff) and answer questions. | Yes | 6 Months | COPD | 55 | 69 (7) | 32 (58) | 55 | 70 (7) | 30 (54) |
| Ireland | ||||||||||||
| Pare, Guy 2013 54 |
RCT | IG: Home telemonitoring (touchscreen, modem) CG: Regular home care visits. |
Touch screen with an integrated modem (TELUSTM) to send clinical data. | No | 21.5 Months | COPD | 60 | 67 (6） | 19 (32) | 60 | 68 (6) | 19 (32) |
| Canada | ||||||||||||
| Pedone, Claudio 2013 55 |
RCT | IG: Multiparametric telemonitoring of vital signs CG: Standard care |
Cellular telephone coupled with wristband containing Bluetooth sensors (heart rate, physical activity, body temperature, and a pulse-oximeter). | No | 9 Months | COPD | 50 | 74 (6) | 36 (72) | 49 | 75 (6) | 31 (63) |
| Italy | ||||||||||||
| Persson, Hans 2020 56 |
Cohort study | IG: Health Diary Telemonitoring and Hospital-Based Home Care (HBCH). | Digital pen and a Health Diary paper form to report daily health status. | No | 12 Months | COPD | 36 | 75 (6) | 14 (39) | NA | NA | NA |
| Sweden | ||||||||||||
| Pinnock, Hilary 2013 57 | RCT | IG: Touch screen telemonitoring equipment + clinical care. CG: Clinical care. |
Touchscreen Telemonitoring equipment to record and transmit daily questionnaires and monitor oxygen. Algorithms alerts. | No | 12 Months | COPD | 128 | 69 (8) | 53 (41) | 128 | 68 (8) | 63 (49) |
| UK | ||||||||||||
| Rasmussen, Linda 2005 58 |
RCT (3 groups) |
IG: Internet-based monitoring asthma tool. CG1: Asthma specialist treatment CG2: General practitioner treatment |
Internet diary or push-button phone. Peak flowmeter (Vitalograph, Ltd, Maid Moriton, Buckingham, United Kingdom). | No | 6 Months | Asthma | 85 | 28 (range 14–44) | 27 (32) | CG1: 88 CG2:80 |
CG1: 30 (range 19–45) CG2:30 (range 20–45) |
CG1: 30 (34) CG2: 30 (38) |
| Denmark | ||||||||||||
| Schou, Lone 2013 59 | RCT | GI: telemedicine-based treatment (videoconferencing system-daily ward rounds) CG: conventional hospital admission |
Touch screen PC and additional devices (pulse oximeter, spirometer, and thermometer) for monitoring the vital signs. | No | 3 Months | COPD | 22 | 68 (12) | 10 (45) | 22 | 73 (10) | 8 (36) |
| Denmark | ||||||||||||
| Stamenova, Vess 2020 60 |
RCT (3 arms) | IG: Technology -Enabled remote monitoring program. CG1: Technology-Enabled Self-Management (web-based) CG2: Standard care |
Web-based portal and Bluetooth devices: custom tablet computer pulse wave wrist cuff monitor, oximeter, weighing scale, and thermometer. | Yes | 6 Months | COPD | 41 | 71 (9) | 23 (56) | CG1: 41 CG: 40 |
CG1: 71 (7) CG2: 72 (9) |
CG1: 23 (56) CG2: 21 (52) |
| Canada | ||||||||||||
| van Gaalen, Johanna 2013 61 |
RCT (multicenter nonblinded, pragmatic randomized controlled parallel trial) | IG: Internet-based self-management support. CG: Usual care. |
Website platform. Handheld spirometer and reporting symptom score. | No | 30 Months | Asthma | 47 | 36 (8) | 12 (26) | 60 | 37 (8) | 19 (32) |
| Netherlands | ||||||||||||
| Vianello, Andrea 2016 62 | RCT | IG: Home telemonitoring (Gateway device for data transmission over telephone) CG: Usual care |
TM system: finger pulse-oximeter and a gateway device for data transmission over a telephone line to a central data management unit located at the Veneto Regional e-Health Centre. | No | 12 Months | COPD | 230 | 75 (6) | 164 (71) | 104 | 76 (6) | 76 (73) |
| Italy | ||||||||||||
| Zairina, Elida 2015 63 | RCT | IG: Telehealth program CG: Usual care |
Mobile application Breathe-easy© supported by a Bluetooth-enabled handheld device (COPD-6 R), which was used for self-monitoring of lung function. | No | 6 Months | Asthma | 36 | 31 (4) | 0 | 36 | 31 (4) | 0 |
| Australia | ||||||||||||
| Telerehabilitation | ||||||||||||
| Bermejo-Gil, Beatriz 2021 64 | Pre-post | IG: Home-based telerehabilitation system (RespiraCon Nosotros) | Web application for respiratory exercises and chat function for interaction compatible with computer, tablet, television, and mobile. | No | 1 Month | COVID-19 | 15 | range 28–38 | 8 (53) | NA | NA | NA |
| Spain | ||||||||||||
| Burkow, Tatjana 2015 65 | Pre-post | IG: PR in home-based online groups (videoconference) | Internet-based comprehensive, multidisciplinary pulmonary rehabilitation program + step counter. | No | 9 Weeks | COPD | 10 | 61 (range 46–72) | 5 (50) | N/A | N/A | N/A |
| Norway | ||||||||||||
| Hansen, Henrik 2020 66 |
RCT | IG: Pulmonary Telerehabilitation program (videoconference). CG: Conventional PR program |
Videoconference software system installed on a single touch screen. | No | 10 Weeks | COPD | 67 | 68 (8) | 32 (48) | 67 | 68 (9) | 28 (42) |
| Denmark | ||||||||||||
| Yuyu 2020 67 | RCT | IG: Pulmonary internet explorer Rehabilitation (PeR) program based on social media (WeChat) CG: Face-to-face PR rehabilitation |
PeR includes two ports: the computer end and the WeChat end. | No | 3 Months | COPD | 53 | 70 (6) | 44 (83) | 53 | 71 (7) | 43 (81) |
| China | ||||||||||||
| Jiménez-Reguera, Begoña 2020 68 |
RCT | IG: mHealth Web-Based platform (HappyAir) CG: Hospital scheduled evaluations. |
HappyAir app: educational program and data collection related to physical activity and disease, recording medication intake, daily exercise time (minutes), level of tiredness and daily mood. | No | 12 Months | COPD | 20 | 68 (6) | 9 (41) | 24 | 68 (7) | 13 (59) |
| Spain | ||||||||||||
| Lewis, Adam 2021 69 | pre-post | IG: Online platform delivery of PR | E-learn Moodle platform (videoconference, messaging) | No | 6 Weeks | COPD | 17 | 69 (10) | 8 (47) | NA | NA | NA |
| UK | ||||||||||||
| Stickland, Michael 2011 70 | RCT | IG: PR delivered via Telehealth CG: PR delivered in person (standard outpatient hospital-based program) |
Videoconference | No | 8 Weeks | COPD | 147 | 69 (8) | 78 (53) | 262 | 69 (9) | 125 (44) |
| Canada | ||||||||||||
| Telemonitoring and telerehabilitation | ||||||||||||
| Benzo, Roberto 2021 71 | RCT | IG: Home-based program with video-guided exercises (website) + phone call health coaching* CG: Waiting list 8 weeks and the intervention was offered afterwards |
Computer tablet: video-guided exercises using an oximeter, an activity monitor and daily self-report of symptoms. | Yes | 8 Weeks | COPD | 72 | 69 (8) | 34 (47) | 74 | 68 (9) | 37 (50) |
| USA | ||||||||||||
| Bhatt, Surya 2019 72 | Matched group design (1:2) | IG: Telehealth PR (video conference) * CG: Contemporaneous subjects who had been hospitalized for a COPD exacerbation but did not receive the intervention |
Smartphone with video capabilities to facilitate two-way live videoconferencing. Automatic sphygmomanometers (blood pressure), and a pulse oximeter (heart rate and oxygen saturation). | Yes | 12 Weeks | COPD | 80 | 64 (10) | 49 (61) | 160 | 63 (11) | 92 (57) |
| USA | ||||||||||||
| Broadbent, Elizabeth 2018 73 |
RCT | IG: iRobi robot (monitor health and prompt medical contact) CG: Standard care |
Robot with Wi-Fi linked smart inhalers: (1) Measure pulse oximetry, forced expiration volume, heart rate, and symptoms, mental state, and functional status using the Clinical COPD Questionnaire (2) reminding medication and inhalers and record their adherence several times a day; (3) remind rehabilitation exercises (4) provide education about COPD; (5) I am feeling unwell function (6) trends over time health status and adherence. | No | 4 Months | COPD | 30 | 70 (10) | 11 (37) | 30 | 69 (9) | 12 (40) |
| New Zealand | ||||||||||||
| Galdiz, Juan 2021 74 |
RCT | IG: Pulmonary Telerehabilitation program (web-based platform) CG: Standard care |
Web-based platform, and a telerehabilitation kit (mobile phone, pulse oximeter, dumbbells and exercise bicycle). | No | 12 Months | COPD | 46 | 62 (8) | 30 (65) | 48 | 63 (6) | 33 (68) |
| Spain | ||||||||||||
| Gilmutdinova, Ilmira R 2021 75 |
pre-post | IG: Telemedicine platform (COVIDREHAB) | A mobile phone, tablet or computer, an Internet connection and an e-mail address on this device. Platform: information and analytical system for remote monitoring of medical rehabilitation. | No | 2 Weeks | COVID-19 | 178 | 50 (range 32–82) | 70 (39) | NA | NA | NA |
| Russia | ||||||||||||
| Holland, Anne 2013 76 | Pre-post | IG: Telerehabilitation (video collaborative software) | A tablet computer was used for videoconferencing. A pulse oximeter (oxyhemoglobin saturation and heart rate). | No | 8 Weeks | COPD | 8 | 66 (range 56–83) | 3 (38%) | NA | NA | NA |
| Australia | ||||||||||||
| Marquis, Nicole 2015 77 | Pre-post | IG: In-home PR (video conferencing system) | Videoconferencing system, internet connection with encrypted transmission. Wireless oximeter (oxygen saturation and heart rate). | Yes | 6 Months | COPD | 23 | 65 (7.1) | 8 (35) | NA | NA | NA |
| Canada | ||||||||||||
| Paneroni, Mara 2015 78 |
controlled, non-randomized pilot study | IG: Telerehabilitation (satellite platform) CG: Standard outpatient rehabilitation program |
Home telemonitoring platform, medical devices (oximeter, steps counter) | Yes | 40 Days | COPD | 18 | 6 5(10) | 16 (89) | 18 | 66 (6) | 15 (83) |
| Italy | ||||||||||||
| Rassouli, Frank 2018 79 |
Observational (pre-post) | IG: Digital multidisciplinary PR (App) | Multiplatform smartphone application with exercise videos. Pedometer. | No | 20 Days | COPD | 34 | 59 (8) | 8 (24) | NA | NA | NA |
| Switzerland, Austria, and Germany | ||||||||||||
| Ringbaek, Thomas 2015 80 |
RCT | IG: Telehealth care (telemonitoring equipment) with the option of video consultation CG: Usual care |
Tablet computer with a web camera, a microphone, and measurement equipment (spirometer, pulse oximeter, and bathroom scale). | Yes | 6 Months | COPD | 141 | 69 (9) | 55 (39) | 140 | 69 (10) | 76 (54) |
| Denmark | ||||||||||||
| Tsai, Ling 2017 81 |
RCT | IG: Home-based telerehabilitation (videoconferencing) CG: Usual care without exercise training |
Computer with an in-built camera, and a finger-tip pulse oximeter. | Yes | 8 Weeks | COPD | 19 | 73 (8) | 12 (63) | 17 | 75 (9) | 6 (86) |
| Australia | ||||||||||||
| Vitacca, Michele 2009 82 |
RCT | IG: Tele-assistance program (modem system through telephone line) CG: Standard care |
Pulse oximetry device with solid memory card + modem telephone. | No | 12 Months | COPD | 57 | 61 (7) | NR | 44 | 61 (17) | NR |
| Italy | ||||||||||||
SD: standard deviation; PR: pulmonary rehabilitation; SBP: standard best practice; N/A: not applicable; NR: not reported.