The use of telehealth remote monitoring interventions was not shown to boost patients' mental and physical quality of life in a study published in the British Medical Journal
, but there were no negative side effects to the treatment either.
Researchers from City University London's School of Health Sciences and other institutions collected self-reported physical and mental quality-of-life scores relating to mobility, self care, ability to perform usual duties, pain and discomfort, anxiety and depression from patients diagnosed with either chronic obstructive pulmonary disease, diabetes or heart failure. Researchers recruited 1,573 patients between May 2008 and December 2009 from primary-care practices, specialist nurses and hospital clinics from the regions of Cornwall, Kent and Newham. Baseline scores were recorded, and scores were collected again at four months and 12 months.
At the start of the study, 845 patients received telehealth interventions and 728 received standard care, which included routine health assessments “at a frequency appropriate for their disease severity,” which ranged from once per week to once or twice a year. Telehealth treatment included the use of systems that monitored vital signs, symptoms and self-management behavior. Telehealth participants were also provided with general and disease-specific health education materials. (Participants dropped out as the study progressed, with only 986 reporting scores at four months and 974 reporting at 12 months.)
“The magnitude of differences between trial arms did not reach … minimal clinically important difference for any outcome in either cohort at four or 12 months,” the researchers concluded.
While the report did not uncover benefits related to telehealth's potential to reduce hospital admissions or slow the decline in quality of life due to chronic illness, the researchers noted that the study also did not uncover any negative findings. They wrote how, in addition to benefits, telehealth has potential for negative quality of life or psychological well being stemming from “the increased burden of self monitoring, concerns about intrusive surveillance, a perceived lack of user friendliness, or the undermining of the traditional (face-to-face) therapeutic relationship.”
In contrast, researchers with the U.S. Veterans Affairs Department, Boston-based Partners Healthcare and Englewood, Colo.-based Centura Health recently reported
that home telehealth monitoring can improve care and patient experiences, reduce hospitalizations and cut costs.
The U.K. researchers noted that their study was not a test of treatment efficacy that would have required a “heavily resourced” randomized control trial. Also, since patients with different types and severity of chronic illness were recruited for the study, attempting to determine the clinical value of the telehealth intervention would be difficult because “Pooling patients with different profiles of long term conditions could mask differential treatment effect.”