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Respir Med. 2018 Oct;143:91-102. doi: 10.1016/j.rmed.2018.09.003. Epub 2018 Sep 8.

Incorporating telemedicine into the integrated care of the COPD patient a summary of an interdisciplinary workshop held in Stresa, Italy, 7-8 September 2017.

Author information

1
Fondazione Mondo Respiro ONLUS, Via Monsignor Cavigioli, 10, 28021, Borgomanero, NO, Italy. Electronic address: cfdonner@mondorespiro.it.
2
Pulmonary and Internal Medicine, 1000 Park Ave, New York, NY, 10028, USA. Electronic address: jmr1000@aol.com.
3
University of CT, Pulmonary and Critical Care, St Francis Hospital and Medical Center, Hartford, CT, 06015, USA. Electronic address: rzuwalla@stfranciscare.org.
4
Brown University, Providence, RI, USA. Electronic address: Linda.Nici@va.gov.
5
Istituti Clinici Scientifici Maugeri, Istituto di Montescano, Italy. Electronic address: nico.ambrosino@gmail.com.
6
ICS Maugeri, I.R.C.C.S. Institute of Veruno (Novara), Italy. Electronic address: bruno.balbi@icsmaugeri.it.
7
School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia. Electronic address: f.blackstock@westernsydney.edu.au.
8
UCLA School of Medicine, Rehabilitation Clinical Trial Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center Torrance, California, 90502, USA. Electronic address: casaburi@ucla.edu.
9
Division of Pneumology, University Hospital RWTH Aachen, Germany. Electronic address: mdreher@ukaachen.de.
10
College of Medicine & Public Health, Flinders University, Adelaide, Australia, Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, Australia. Electronic address: Tanja.Effing@health.sa.gov.au.
11
University of Toronto, NSA Chair in Respiratory Rehabilitation Research, USA. Electronic address: roger.goldstein@westpark.org.
12
University of Illinois, USA. Electronic address: jakris@uic.edu.
13
College of Nursing, Univ. of Colorado Denver, Anschutz Medical Campus, C288-04, ED 2 North, Rm 4327, 13120 East 19th Ave, Aurora, CO, 80045, USA. Electronic address: Suzanne.Lareau@ucdenver.edu.
14
Department of Medicine, University of Colorado, USA. Electronic address: makeb@njhealth.org.
15
Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada. Electronic address: Francois.Maltais@fmed.ulaval.ca.
16
College of Nursing, Anschutz Medical Campus, University of Colorado, USA. Electronic address: paula.meek@ucdenver.edu.
17
University of Leicester, Chair NHS England Respiratory Clinical Reference Group, National Clinical Director Respiratory NHS, UK. Electronic address: Julie.spence@uhl-tr.nhs.uk.
18
Sleep and Exercise Department, Scientific Director of Clinical Research Administration, Research Division at Grenoble University Hospital, Grenoble, FR, France. Electronic address: Jpepin@chu-grenoble.fr.
19
Rabbito Law Firm, Via Piave 44, San Lazzaro, 40068, BO, Italy. Electronic address: crabbito@avvocatorabbito.it.
20
Yale University School of Medicine, Pulmonary Rehabilitation Program, VA Connecticut Healthcare System, USA. Electronic address: carolyn.rochester@yale.edu.
21
Quinnipiac University School of Medicine, 95 Woodland St, 4th Floor, Hartford, CT, 06105, USA. Electronic address: asilverm@trinityhealthofne.org.
22
University Hospitals of Leicester Leicester, UK. Electronic address: sally.singh@uhl-tr.nhs.uk.
23
Department of Research and Education, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands; REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium. Electronic address: martijnspruit@ciro-horn.nl.
24
Respiratory Department ICS S. Maugeri IRCCS Lumezzane (Bs) Italy, Respiratory Department, Via Mazzini 129, Lumezzane, 25066, Bs, Italy. Electronic address: michele.vitacca@icsmaugeri.it.
25
Management Program, Pulmonary and Critical Care, St Francis Hospital & Med Ctr, Hartford, CT, 06105, USA. Electronic address: lwilliam@stfranciscare.org.

Abstract

This report is a summary of a workshop focusing on using telemedicine to facilitate the integrated care of chronic obstructive pulmonary disease (COPD). Twenty-five invited participants from 8 countries met for one and one-half days in Stresa, Italy on 7-8 September 2017, to discuss this topic. Participants included physiotherapists, nurses, a nurse practitioner, and physicians. While evidence-based data are always at the center of sound inference and recommendations, at this point in time the science behind telemedicine in COPD remains under-developed; therefore, this document reflects expert opinion and consensus. While telemedicine has great potential to expand and improve the care of our COPD patients, its application is still in its infancy. While studies have demonstrated its effectiveness in some patient-centered outcomes, the results are by no means consistently positive. Whereas this tool may potentially reduce health care costs by moving some medical interventions from centralized locations in to patient's home, its cost-effectiveness has had mixed results and telemonitoring has yet to prove its worth in the COPD population. These discordant results should not be unexpected in view of patient complexity and the heterogeneity of telemedicine. This is reflected in the very limited support offered by the National Health Services to a wider application of telemedicine in the integrated care of COPD patients. However, this situation should challenge us to develop the necessary science to clarify the role of telemedicine in the medical management of our patients, providing a better and definitive scientific basis to this approach.

KEYWORDS:

COPD; Integrated care; Telehealth; Telemedicine; Telerehabilitation

PMID:
30261999
DOI:
10.1016/j.rmed.2018.09.003

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