The Health Diary Telemonitoring and Hospital-Based Home Care Improve Quality of Life Among Elderly Multimorbid COPD and Chronic Heart Failure Subjects
Received 26 October 2019
Accepted for publication 24 January 2020
Published 9 March 2020 Volume 2020:15 Pages 527—541
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Hans Lennart Persson,1,2 Johan Lyth,3,4 Leili Lind5,6
1Department of Respiratory Medicine in Linköping, Linköping University, Linköping SE-581 85, Sweden; 2Department of Biomedical and Clinical Sciences, Linköping University, Linköping SE-581 85, Sweden; 3Research and Development Unit in Region Östergötland, Linköping University, Linköping SE-581 85, Sweden; 4Department of Health, Medicine and Caring Sciences, Linköping University, Linköping SE-581 85, Sweden; 5Department of Biomedical Engineering/Health Informatics, Linköping University, Linköping SE-581 85, Sweden; 6Digital Systems Division, Department of Industrial Systems, RISE Research Institutes of Sweden, Linköping University, Linköping, S-581 83, Sweden
Correspondence: Hans Lennart Persson
Department of Respiratory Medicine in Linköping, Linköping University, Linköping SE-581 85, Sweden
Tel +46 13 10 1033621
Background: Elderly, multimorbid patients with advanced chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF) exhibit poor health-related quality of life (HRQoL). Telemonitoring, based on digital pen technology, supported by hospital-based home care (HBHC) significantly reduces the number of hospitalizations. We hypothesized that the same intervention would prevent the deterioration of HRQoL that follows upon disease progression.
Methods: Elderly computer-illiterate subjects with ≥ 2 hospitalizations the previous year were included. HRQoL was assessed at inclusion (baseline) and at 1, 6 and 12 months employing EuroQol-5 Dimensions (EQ-5D) and RAND-36 for general HRQoL, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) and St. Georges Respiratory Questionnaire (SGRQ) for disease-specific HRQoL. Healthcare contacts, hospitalizations, as-needed medications, prescription changes and healthcare costs were registered.
Results: Ninety-four patients were enrolled of which 53 subjects completed the 12-month study period. Compared to baseline, most domains of RAND-36 were improved significantly at 1 time-point or more. Only among COPD subjects, the disease-specific HRQoL was worsened at the 12 month evaluation. Measures of healthcare dependency were associated with poor HRQoL.
Conclusion: The Health Diary system and HBHC together improve general HRQoL, and measures of healthcare dependency are associated with HRQoL variables.
Keywords: digital pen, exacerbation, home care services, hospital-based, hospitalization, multimorbidity, telemedicine, QoL
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