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Randomised crossover trial of telemonitoring in chronic respiratory patients (TeleCRAFT trial).

Chatwin, M; Hawkins, G; Panicchia, L; Woods, A; Hanak, A; Lucas, R; Baker, E; Ramhamdany, E; Mann, B; Riley, J; et al. Chatwin, M; Hawkins, G; Panicchia, L; Woods, A; Hanak, A; Lucas, R; Baker, E; Ramhamdany, E; Mann, B; Riley, J; Cowie, MR; Simonds, AK (2016) Randomised crossover trial of telemonitoring in chronic respiratory patients (TeleCRAFT trial). Thorax, 71 (4). pp. 305-311. ISSN 1468-3296 https://doi.org/10.1136/thoraxjnl-2015-207045
SGUL Authors: Baker, Emma Harriet

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Abstract

OBJECTIVE: To assess the impact of home telemonitoring on health service use and quality of life in patients with severe chronic lung disease. DESIGN: Randomised crossover trial with 6 months of standard best practice clinical care (control group) and 6 months with the addition of telemonitoring. PARTICIPANTS: 68 patients with chronic lung disease (38 with COPD; 30 with chronic respiratory failure due to other causes), who had a hospital admission for an exacerbation within 6 months of randomisation and either used long-term oxygen therapy or had an arterial oxygen saturation (SpO2) of <90% on air during the previous admission. Individuals received telemonitoring (second-generation system) via broadband link to a hospital-based care team. OUTCOME MEASURES: Primary outcome measure was time to first hospital admission for an acute exacerbation. Secondary outcome measures were hospital admissions, general practitioner (GP) consultations and home visits by nurses, quality of life measured by EuroQol-5D and hospital anxiety and depression (HAD) scale, and self-efficacy score (Stanford). RESULTS: Median (IQR) number of days to first admission showed no difference between the two groups-77 (114) telemonitoring, 77.5 (61) control (p=0.189). Hospital admission rate at 6 months increased (0.63 telemonitoring vs 0.32 control p=0.026). Home visits increased during telemonitoring; GP consultations were unchanged. Self-efficacy fell, while HAD depression score improved marginally during telemonitoring. CONCLUSIONS: Telemonitoring added to standard care did not alter time to next acute hospital admission, increased hospital admissions and home visits overall, and did not improve quality of life in chronic respiratory patients. TRIAL REGISTRATION NUMBER: NCT02180919 (ClinicalTrials.gov).

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: COPD Exacerbations, Respiratory Infection, Respiratory System, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Thorax
ISSN: 1468-3296
Language: ENG
Dates:
DateEvent
29 December 2015Accepted
9 March 2016Published Online
1 April 2016Published
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 26962013
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107775
Publisher's version: https://doi.org/10.1136/thoraxjnl-2015-207045

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