Editorials

Telemonitoring for patients with COPD

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5932 (Published 17 October 2013) Cite this as: BMJ 2013;347:f5932
  1. Rachel Jordan, senior lecturer,
  2. Peymane Adab, professor,
  3. Kate Jolly, professor
  1. 1School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
  1. r.e.jordan{at}bham.ac.uk

Adds little to well supported self management

Telemonitoring has been promoted as a potential solution to the management of rising numbers of patients worldwide with long term health problems. Although there is some evidence that such interventions empower patients to change behaviour, their effect on clinical outcomes is not clear.1 In a linked paper (doi:10.1136/bmj.f6070), Pinnock and colleagues report the results of their telemonitoring trial in 256 patients with chronic obstructive pulmonary disease (COPD) admitted to hospital in the previous year with an exacerbation.2

COPD is one of the most common long term conditions and is expensive because exacerbations often lead to hospital admission. Patients are encouraged to self manage their disease by recognising exacerbations and self medicating to limit the impact of an exacerbation (action planning), thus avoiding admission. Cochrane systematic reviews conclude that education on self management is associated with a reduced risk of hospital admission,3 although action plans with limited education have no effect.4

Another approach to timely management of exacerbations is the telemonitoring of patients’ symptoms by a remote clinical team, although evidence for the effectiveness of this approach is conflicting. Systematic reviews highlight the heterogeneity of interventions and the difficulty in isolating the …

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