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 esther@talboom.info T +31 6 54 23 83 33 / esthertalboom

Esther Talboom-Kamp