TY - JOUR T1 - Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis JF - British Journal of General Practice JO - Br J Gen Pract SP - e739 LP - e749 DO - 10.3399/bjgp12X658269 VL - 62 IS - 604 AU - Susannah McLean AU - Ulugbek Nurmatov AU - Joseph LY Liu AU - Claudia Pagliari AU - Josip Car AU - Aziz Sheikh Y1 - 2012/11/01 UR - http://bjgp.org/content/62/604/e739.abstract N2 - Background Chronic obstructive pulmonary disease (COPD) is common. Telehealthcare, involving personalised health care over a distance, is seen as having the potential to improve care for people with COPD.Aim To systematically review the effectiveness of telehealthcare interventions in COPD to improve clinical and process outcomes.Design and setting Cochrane Systematic Review of randomised controlled trials.Methods The study involved searching the Cochrane Airways Group Register of Trials, which is derived from the Cochrane Central Register of Controlled Trials, MEDLINE®, embase™, and CINAHL®, as well as searching registers of ongoing and unpublished trials. Randomised controlled trials comparing a telehealthcare intervention with a control intervention in people with a clinical diagnosis of COPD were identified. The main outcomes of interest were quality of life and risk of emergency department visit, hospitalisation, and death. Two authors independently selected trials for inclusion and extracted data. Study quality was assessed using the Cochrane Collaboration’s risk of bias method. Meta-analysis was undertaken using fixed effect and/or random effects modelling.Results Ten randomised controlled trials were included. Telehealthcare did not improve COPD quality of life: mean difference –6.57 (95% confidence interval [CI] = –13.62 to 0.48). However, there was a significant reduction in the odds ratios (ORs) of emergency department attendance (OR = 0.27; 95% CI = 0.11 to 0.66) and hospitalisation (OR = 0.46; 95% CI = 0.33 to 0.65). There was a non-significant change in the OR of death (OR = 1.05; 95% CI = 0.63 to 1.75).Conclusion In COPD, telehealthcare interventions can significantly reduce the risk of emergency department attendance and hospitalisation, but has little effect on the risk of death. ER -