Home-Based Telehealth Not Effective for Chronic Conditions
No benefit on quality of life, psych outcomes for patients with COPD, diabetes, heart failure
WEDNESDAY, Feb. 27 (HealthDay News) -- Second-generation, home-based telehealth is no more effective than usual care for quality of life and psychological outcomes among patients with chronic health conditions, according to research published online Feb. 26 in BMJ.
Martin Cartwright, Ph.D., from City University London, and colleagues compared the effect of second-generation, home-based telehealth with usual care on health-related quality of life, anxiety, and depressive symptoms in patients with chronic obstructive pulmonary disease, diabetes, or heart failure. Intention-to-treat analyses were conducted for 759 participants in the Whole Systems Demonstrator telehealth questionnaire study who completed questionnaires at baseline, four, and 12 months (complete case cohort), and for 1,201 participants who completed questionnaires at baseline and one other assessment (available case cohort). Treatment efficacy was assessed in a per-protocol analysis, involving 633 participants in the complete case cohort and 1,108 participants in the available case cohort.
The researchers found that in the complete case and available case cohorts, in intention-to-treat analyses, the differences between treatment groups were small and not significant. The trial-defined minimal clinically important difference was not reached for the magnitude of the difference between the groups in any outcome at four or 12 months. In the per-protocol analyses there were no significant differences in the main effects of telehealth versus usual care for any outcome.
"Second-generation, home-based telehealth as implemented in the Whole Systems Demonstrator evaluation was not effective or efficacious compared with usual care only," Cartwright and colleagues conclude.