l

The content of this website is intended for healthcare professionals only

Home-based telehealth does not improve quality of life

Telehealth makes no difference to patients with long-term conditions

Adrian O'Dowd

Wednesday, 27 February 2013

Using home-based telehealth to improve quality of life makes no difference to patients with diabetes, COPD or heart failure, concludes a study published online today in the BMJ.

The study has recommended that, contrary to government policy, second generation home-based telehealth should not be used as a tool to achieve improvements in generic health related quality of life (QoL) or psychological outcomes.

The conclusion from the Department of Health funded study – part of the Whole Systems Demonstrator Trial (one of the largest and most comprehensive investigations of telehealth and telecare ever conducted) – flies in the face of the government’s plans.

In November of last year 1, health secretary Jeremy Hunt said he wanted three million people in England to have access to telehealth by 2017 and there are seven pathfinder sites including CCGs who are currently piloting its use amongst 100,000 patients.

Telehealth uses technology to help people with health problems live more independently at home and is designed to help people to measure blood pressure or blood glucose levels at home with results electronically transmitted to a health professional, reducing the need for hospital visits.

For long-term conditions, telehealth has been promoted to reduce healthcare costs while improving health related quality of life, but evidence to support this is mixed.

A team of UK researchers, therefore, set out to assess the impact of second generation home based telehealth on generic health related quality of life, anxiety and depressive symptoms over 12 months in patients with long-term conditions.

The study was carried out at 154 GP practices in three regions of England (Cornwall, Kent and London) and 1,573 patients with COPD, diabetes or heart failure took part.

The patients were split into two roughly equally groups – one used telehealth and the other received usual treatment.

All participating patients filled in questionnaires at the start of the study, and again at four and 12 months. The questionnaires asked about their quality of life, anxiety and depressive symptoms and the results were assessed using recognised scoring scales.

Overall, the findings showed that, compared with usual care, second generation telehealth had no effect on generic health related quality of life, anxiety, or depressive symptoms for patients with COPD, diabetes, or heart failure over 12 months.

Further analyses across different measures did not alter the results, and the authors said the findings suggested that concerns about potentially harmful effect of telehealth were unfounded for most patients.

They concluded: “More research is required to understand the many potential beneficial and harmful mechanisms by which telehealth could affect patient reported outcomes.

“However, our findings strongly suggest no net benefit from telehealth; therefore, it should not be used as a tool to improve health related QoL or psychological outcomes.”

DOI: 10.1136/bmj.f653

  1. OnMedica, 16 November 2012. Telehealth expansion to be headed by CCGs

Registered in England and Wales. Reg No. 2530185. c/o Wilmington plc, 5th Floor, 10 Whitechapel High Street, London E1 8QS. Reg No. 30158470