J.H.KOH1, L.C.Y.CHONG1, G.KOH2, S.TYAGI2
National University of Singapore1, MOH Office for Healthcare Transformation Pte Ltd2
Chronic obstructive pulmonary disease (COPD) is a growing epidemic, with a heavy associated economic burden. Education, physical activity, and pulmonary rehabilitation delivered via telemedicine interventions are important aspects of the management of COPD. Several systematic reviews and meta-analyses have been conducted to assess the effectiveness of these interventions. We thus sought to conduct an umbrella review to critically appraise and summarise the available evidence on the efficacy of telemedicine interventions for the management of COPD.
Medline, Embase, Scopus, Web of Science, PsycINFO and Cochrane databases were searched for systematic reviews or meta-analyses of randomised controlled trials relating to telemedicine interventions for the management of COPD. A narrative synthesis was performed. Based on the level of evidence, we formulated specific recommendations for clinical practice.
We screened 576 studies and included 10 systematic reviews or meta-analyses which met the inclusion criteria. The included reviews encompassed the following intervention categories: tele treatment, telemonitoring, tele support or a combination of these. Telemedicine interventions were associated with significant improvements in quality of life and significant reduction in visits to the emergency department. There were also significant improvements in functional dyspnoea, and objective physical activity. Telemedicine interventions also led to significant cost savings compared with usual care.
Telemedicine interventions showed non-inferiority or superiority over standard of care for the management of COPD. Especially within the context of the COVID-19 pandemic, telemedicine interventions should be considered as a safe and efficacious alternative to usual methods of care for the outpatient management of COPD.