Introduction
There is an increased interest in the possibility of using telemedicine to aid the management of chronic diseases such as chronic obstructive pulmonary disease (COPD) (Barken et al., 2018). Some of the possible ways that telemedicine may be used in taking care of patients with COPD include in-home monitoring, medical consultations, and remote rehabilitation. Teleconsultations have shown a considerable amount of success in some critical factors like time and costs. It is much easier for patients to access medical attention, even those in the country's remotest parts, without necessarily having to go miles in search of services. Despite that, many studies encourage telehealth as an alternative treatment method for people living in remote areas. Telehealth makes it possible to attend more patients considering that hospitals may not be enough to accommodate all the patients. The impact of telemedicine in reducing exacerbations, reducing healthcare utilization, and saving on costs is still considered equivocal. There are arguments raised against the use of telemedicine in managing COPD among adults. The main reason is the healthcare costs and the kind of commitment required in telemonitoring and in the detection of exacerbations. However, emerging evidence derived from preliminary trials of telerehabilitation of patients with pulmonary disease is encouraging. They show that telehealth may be a vital move in building capacity and increasing access, especially in remote areas.
Background and Significance
Respiratory patients tend to have the most home-adapting problems, and according to statistics, they have higher chances of rehospitalization in the next thirty days after being discharged. That means 1 of 4 or 5 patients suffering from COPD are likely to get readmitted. There are numerous ways through which these patients may be assisted, and the best of them is telehealth. Telemedicine ensures that there is proper distribution of services as offered by physicians, healthcare distributors, and providers without necessarily having to worry about the distance they would have to travel to get the patients treated (Cordova et al., 2016). That is done through exchanging information on diagnosis and treatment through information and communication technologies.
Over the past decade, an increased interest in the application of telemedicine in the management and treatment of COPD has shown positive outcomes (Barken et al., 2018). However, much needs to be done to improve the results (Cordova et al., 2016). Telemedicine technology and devices are being used in taking care of people with chronic obstructive pulmonary disease in the provision of medical consultations, monitoring of patients receiving treatment at home, and in remote pulmonary rehabilitation (Walker et al., 2018). In telemedicine consultations, the physician and the patient connect through a video conference device instead of necessarily meeting in person (Walker et al., 2018). This method of communication is proof that telemedicine is feasible and acceptable in managing patients with a variety of pulmonary illnesses such as COPD.
Theoretical Framework
Chronic obstructive pulmonary disease (COPD) has many connective problems induced by the patients' long-life survival, the exacerbation rate, and prolonged admissions (Walker et al., 2018). If we focus on self-management that is done through various interventions such as written action plans and direct communication with healthcare providers, it is still enough to note that there is a higher probability of improving an individual's health status and ensure that lower chances of getting this respiratory disease are lowered (Barken et al., 2018). Some of the major problems faced as a result of patients transitioning from home are heterogeneity, multidimensional diseases, and practitioners' education level, among other factors (Barken et al., 2018). To make sure that practitioners can prevent the disease from worsening, embracing the rapidly developing technologies and information is a vital weapon (Walker et al., 2018). The use of the new technologies is also critical for earlier detection of exacerbations and promotes early therapeutic interventions before the illness worsens (Barken et al., 2018). Nonetheless, the study shows that telemedicine is an excellent way to deal with chronic obstructive pulmonary disease while considering several facts.
Methods
Various scholars have argued that telemonitoring of COPD patients could be easily done through telemedicine, offering different reasoning forms to support their claims. For instance, according to Milkowska-Dymanowska et al. (2018), in an attempt to compare a specific telemedicine system and a routine clinical practice in cases involving COPD, telemonitoring equipment is used to measure blood pressure and heart failure was used (Rajan et al., 2019). However, the experiment was not a success since comparing it with routine practice made it impossible to prove whether telemonitoring can reduce emergency admissions and hospitalization (Milkowska-Dymanowska et al., 2018).
Telecommunication devices allow for evaluating, diagnosing, and treating patients by healthcare providers (Mileski et al., 2017). This is done through the use of smartphones and video conferencing. Besides, telemedicine's role has increased as different parties are seeking more efficient ways of providing care at less cost (Cordova et al., 2016). It provides a way for patients to consult with physicians on minor issues or other non-urgent medical needs without the need to visit the emergency department or the primary care physician (Milkowska-Dymanowska et al., 2018). Chronic diseases can be described as those which last for three or more months. Moreover, most of the conditions generally may not be prevented by vaccination or cured by medication. The prevalence of the conditions increases with age. Some of these conditions include gout, arthritis, diabetes, hypertension, obesity, and stroke, among others (Rajan et al., 2019). The paper provides an analysis of articles that address telemedicine's use in supporting patients with chronic conditions.
The first article was written by Orozco-Beltran, Sánchez-Molla, Sanchez, Mira, and the ValCrònic Research Group (2017). This research was motivated by the increased prevalence of chronic disease, which has developed the need to adapt the model of care aimed at providing greater home supervision. Furthermore, it aimed at evaluating the importance of telemonitoring of patients with several chronic conditions that include hypertension, diabetes, chronic obstructive pulmonary disease, and heart failure (Orozco-Beltran et al., 2017). These conditions were considered because of the high risk of emergency department visits or rehospitalization in control of the disease. It included the completion of a quasi-experimental study that was completed after one year. Five hundred twenty-one patients were included in the study (Orozco-Beltran et al., 2017). The findings revealed that there were reductions in the patients' weight, the systolic and diastolic pressures, and hemoglobin A1c which is used in the monitoring of diabetes. Additionally, there was a decrease in the number of patients who visited the emergency departments for primary care and fewer admissions. The rate of disease exacerbations also decreased significantly (Orozco-Beltran et al., 2017). The findings resulted in the conclusion that the ValCronic telemonitoring program is effective for the improvement of control over target chronic conditions in reducing rehospitalization and also in the reduction of the use of resources (Orozco-Beltran et al., 2017).
The second article was documented by Rajan, Tezcan, and Seidmann (2019). The article was formulated based on the fact that medical specialists who handle chronic conditions also handle patients' heterogeneous set. The heterogeneity originates from the differences in each patient's medical conditions and the burden of traveling to the primary care facility occasionally faced by each individual (Rajan et al., 2019). Besides, the researchers provide a comparison of the strategic behavior between specialists who maximize revenue and those who maximize welfare. The findings are that the revenue-maximizing specialists have shorter waiting times, serve a small population of patients, and spend more time with their patients. They also analyzed the impact of telemedicine on operating decisions of specialists and patient utility (Rajan et al., 2019). The paper proves that since telemedicine's introduction, health care specialists have posted increased productivity and overall social welfare.
However, some patients are still not posting improvement in their symptoms. The findings suggest that telemedicine should be expanded to be for more chronically ill patients.
Mileski et al., (2017) document an article on the adoption of telemedicine among hypertension patients who are self-managing themselves. This article's motivation was the high prevalence of hypertension in the United States, which affects one in every three adults and costs the country 46 billion dollars every year in terms of medications and health care services (Mileski et al., 2017). Besides, it necessitates the need to find easier ways for management of the condition. Telemedicine seems like a solution to reducing the number of visits to the physician for patients diagnosed with hypertension. Nonetheless, there is limited research on the effects of its use. The article documents a comparison between the facilitators and barriers to telemedicine through the use of a systematic review. The facilitators to telemedicine use include an increase in the quality of health, improved involvement, and knowledge of patients, increased access to care, increased convenience, and effectiveness. Nevertheless, it presents with the barriers of difficulty in maintaining self-management, lack of evidence, and difficulty in maintaining long term workload commitment (Mileski et al., 2017). The information provided from the article means that telemedicine can be successfully implemented if appropriate measures are taken to address the barriers.
The fourth article was written by Fraser, et al., (2017). The use of telehealth in the management of the chronic disease has been documented to be a cost-effective measure in healthcare delivery. However, its use in the delivery of care to indigenous people has not been illustrated (Fraser et al., 2017). The authors examine telemedicine's use in the management of chronic conditions among indigenous people by completing a systematic review of already completed qualitative studies. The findings revealed that telemedicine is effective for the management of chronic needs among the indigenous people, but there are concerns about their cultural safety. That means that there is a need to deliver culturally competent healthcare in the use of telemedicine among indigenous people (Fraser et al., 2017). This should be done through proper consultation and cultural competency education of health professionals to ensure improved indigenous people's health care.
Voruganti, Grunfeld, Makuwaza, and Bender (2017) documented an article on using web-based tools in the provision of communication between patients and providers. The patients diagnosed with chronic conditions require ongoing care that necessitates frequents visits to the primary care physicians, outside appointments, and self-management (Voruganti et al., 2017). Moreover, web-based tools allow for communication between patients and their providers, allowing them to share contextual information and personal narrative in a simple and accessible manner. The paper's findings reveal that most of th...
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