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J Med Internet Res. 2018 Feb 13;20(2):e45. doi: 10.2196/jmir.8640.

Using Robots at Home to Support Patients With Chronic Obstructive Pulmonary Disease: Pilot Randomized Controlled Trial.

Author information

1
Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
2
Department of Respiratory Medicine, Counties Manukau District Health Board, Auckland, New Zealand.
3
Acute Allied Health Department, Counties Manukau District Health Board, Auckland, New Zealand.
4
Department of Electrical and Computer Engineering, The University of Auckland, Auckland, New Zealand.
5
School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
6
School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
7
Department of Accounting and Finance, The University of Auckland, Auckland, New Zealand.
8
Department of Statistics, The University of Auckland, Auckland, New Zealand.

Abstract

BACKGROUND:

Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD). Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization.

OBJECTIVE:

This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group.

METHODS:

At discharge from hospital for a COPD admission, 60 patients were randomized to receive a robot at home for 4 months or to a control group. Number of hospitalization days for respiratory admissions over the 4-month study period was the primary outcome. Medication adherence, frequency of rehabilitation exercise, and quality of life were also assessed. Implementation interviews as well as benefit-cost analysis were conducted.

RESULTS:

Intention-to-treat and per protocol analyses showed no significant differences in the number of respiratory-related hospitalizations between groups. The intervention group was more adherent to their long-acting inhalers (mean number of prescribed puffs taken per day=48.5%) than the control group (mean 29.5%, P=.03, d=0.68) assessed via electronic recording. Self-reported adherence was also higher in the intervention group after controlling for covariates (P=.04). The intervention group increased their rehabilitation exercise frequency compared with the control group (mean difference -4.53, 95% CI -7.16 to -1.92). There were no significant differences in quality of life. Of the 25 patients who had the robot, 19 had favorable attitudes.

CONCLUSIONS:

This pilot study suggests that a homecare robot can improve adherence to medication and increase exercise. Further research is needed with a larger sample size to further investigate effects on hospitalizations after improvements are made to the robots. The robots could be especially useful for patients struggling with adherence.

TRIAL REGISTRATION:

Australian New Zealand Clinical Trials Registry ACTRN12615000259549; http://www.anzctr.org.au (Archived by WebCite at  http://www.webcitation.org/6whIjptLS).

KEYWORDS:

chronic obstructive pulmonary disease; hospitalization; medication adherence; rehabilitation exercise; robotics; telehealth

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