11 september esther talboom-kamp ers congress milan 2017...
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Esther Talboom-Kamp ERS congress Milan 2017 Effect on health status of integrated self-management platforms in COPD disease management
11 September
Urgency: Low involvement
patient
607.300 2015 NL
Primary cause:
tobacco smoke
eHealth is beneficial for
chronic patients
Chronic obstructive pulmonary disease, a slowly progressive lung disease COPD
Telemonitoring integrated into COPD care: Not effective in postponing admissions No improvement in quality of life
Telehealth vs usual care in primary care: No improvement of quality of life or psychological outcomes
3230 patients DM, COPD, HF
179 general practices
Telehealth vs usual care for chronic patients:
WSD
Telehealth is associated with lower mortality and emergency admission rates
Consultation measurement Pageviews (x mln)
3
2
1
0 time consultations before
consultations after
pageviews website
2009 2010 2011 2012 2013 2014
400
300
200
Study design COPD
High Medium None
n=90 n=90 n=45
n=45 n=45 n=45 n=45 n=45
1 2 3
ITS and multilevel linear regression modelling
Health status CCQ before and after intervention total group
Health status CCQ time (months)
1.50
1.40
1.30
1.20
1.10
1.00
0.90
0.80
Slope before
-2 0 15
p=0.334
Slope after
1.50
1.40
1.30
1.20
1.10
1.00
0.90
0.80
Health status CCQ before and after intervention subgroup analyses CCQ
p=0.429
time (months) -2 0 15
A = HIGH ASSISTANCE B = LOW ASSISTANCE
Patient perspective
Conclusions & discussion
Personal assistance of patients increases use of eHealth
Education for healthcare professionals to take a different role is necessary
No beneficial impact on health status CCQ
Organizational perspective
Blended care set up increases use of eHealth
Behavorial change and improvement of health status takes more time
High standard of usual care with little room for improvement
Researcher LUMC Chairman of the Board Saltro Boardmember InEen & Zelfzorg Ondersteund MD, MBA Niels Chavannes, Mattijs Numans, Noortje Verdijk, Marise Kasteleyn E [email protected] T +31 6 54 23 83 33 / esthertalboom
Esther Talboom-Kamp