Use, Utility and Methods of Tele-Health for COPD patients in England and Wales: a health-care provider survey

Introduction: Although the effectiveness of domiciliary monitoring (tele-health) to improve outcomes in Chronic Obstructive Pulmonary Disease (COPD) is controversial, it is being used in the NHS. Aim: To explore the use of tele-heath for COPD across England and Wales, to assess the perceptions of clinicians employing tele-health in COPD and to summarise the techniques that have been used by healthcare providers to personalise alarm limits for COPD patients enrolled in tele-health programmes. Methods: A cross-sectional survey consisting of 14 questions was sent to 230 COPD community services in England and Wales. Questions were designed to cover five aspects of tele-health in COPD: purpose of use, equipment type, clinician perceptions, variables monitored, and personalisation of alarm limits. Results: 65 participants completed the survey from 52 different NHS Trusts. 46% of Trusts had used tele-health for COPD, and currently, 31% still provided tele-health services to patients with COPD. Tele-health is most commonly used for baseline monitoring and to allow early detection of exacerbations, with 54% believing it to be effective. The three most commonly monitored variables were oxygen saturation, heart rate and breathlessness. A variety of methods were used to set alarm limits with the majority of respondents believing that at least 40% of alarms were false. Conclusion: Around one third of responded community COPD services are using tele-health, believing it to be effective without robust evidence, with a variety of variables monitored, a variety of hardware, and varying techniques to set alarm limits with high false-alarm frequencies.