scholarly journals Mortality associated with tiotropium mist inhaler in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis of randomised controlled trials

BMJ ◽  
2011 ◽  
Vol 342 (jun14 1) ◽  
pp. d3215-d3215 ◽  
Author(s):  
S. Singh ◽  
Y. K. Loke ◽  
P. L. Enright ◽  
C. D. Furberg
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Obstructive Pulmonary Disease ◽  
Randomised Controlled

scholarly journals Telehealth for patients with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021865 ◽  
Author(s):  
Violeta Gaveikaite ◽  
Claudia Fischer ◽  
Helen Schonenberg ◽  
Steffen Pauws ◽  
Spyros Kitsiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Meta Analysis ◽  
Hospital Readmissions ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Obstructive Pulmonary Disease

IntroductionChronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease characterised by persistent respiratory symptoms. A focus of COPD interventional studies is directed towards prevention of exacerbations leading to hospital readmissions. Telehealth as a method of remote patient monitoring and care delivery may be implemented to reduce hospital readmissions and improve self-management of disease. Prior reviews have not systematically assessed the efficacies of various telehealth functionalities in patients with COPD at different stages of disease severity. We aim to evaluate which COPD telehealth interventions, classified by their functionalities, are most effective in improving patient with COPD management measured by both clinical and resource utilisation outcomes.Methods and analysisWe will conduct a systematic review which will include randomised controlled trials comparing the efficacy of telehealth interventions versus standard care in patients with COPD with confirmed disease severity based on forced expiratory volume(%) levels. An electronic search strategy will be used to identify trials published since 2000 in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINHAL. Telehealth is described as remote monitoring and delivery of care where patient data/clinical information is routinely or continuously collected and/or processed, presented to the patient and transferred to a clinical care institution for feedback, triage and intervention by a clinical specialist. Two authors will independently screen articles for inclusion, assess risk of bias and extract data. We will merge studies into a meta-analysis if the interventions, technologies, participants and underlying clinical questions are homogeneous enough. We will use a random-effects model, as we expect some heterogeneity between interventions. In cases where a meta-analysis is not possible, we will synthesise findings narratively. We will assess the quality of the evidence for the main outcomes using GRADE.Ethics and DisseminationResearch ethics approval is not required. The findings will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42018083671.

Effectiveness of telemonitoring versus usual care for chronic obstructive pulmonary disease: A systematic review and meta-analysis

2018 ◽  
Vol 26 (4) ◽  
pp. 189-199 ◽  
Author(s):  
Ah-Ram Sul ◽  
Da-Hyun Lyu ◽  
Dong-Ah Park
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Confidence Interval ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Control Groups ◽  
Obstructive Pulmonary Disease ◽  
Randomised Controlled ◽  
And Control

Aims The purpose of this research was to investigate the effectiveness of telemonitoring for chronic obstructive pulmonary disease. Methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and CINAHL up to September 2018. We selected randomised controlled trials comparing telemonitoring and control groups for chronic obstructive pulmonary disease management. Two reviewers independently examined articles based on eligibility, extracted data and evaluated the risk of bias. The Cochrane tool was applied for assessing the risk of bias. The 95% confidence interval was calculated. Results A total of 28 randomised controlled trials were included. Meta-analysis revealed that there were no variables showing a statistically significant difference between telemonitoring and control groups. Chronic obstructive pulmonary disease exacerbation rate (six studies) was not different between two groups (risk ratio 0.67, 95% confidence interval 0.31–1.42). Subgroup analysis showed that telemonitoring reduced exacerbation rates when the intervention continued for longer than six months or pulmonary function was monitored. No differences between groups were noticed for mortality (seven studies, risk ratio 0.89, 95% confidence interval 0.60–1.34). Similarly, no differences between groups were observed in the patient-reported outcomes (St George’s Respiratory Questionnaire, Chronic Respiratory Disease Questionnaire-Dyspnea score) and for health service utilization (length of hospital stay, number of hospital admissions, number of emergency room visits). Conclusions Telemonitoring for chronic obstructive pulmonary disease was unlikely to result in statistically significant improvements in health outcomes. However, our novel finding was that at least six months of intervention duration and monitoring of pulmonary function play roles in activating the effects of telemonitoring.

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