Effectiveness of a telenursing intervention program in reducing exacerbations in patients with chronic respiratory failure receiving noninvasive positive pressure ventilation: A randomized controlled trial

Telenursing for patients with chronic respiratory failure receiving noninvasive positive pressure ventilation (NPPV) is an important aid in reducing exacerbations; however, there is insufficient evidence. This randomized controlled trial aimed to investigate the effectiveness of a telenursing intervention program in reducing exacerbations in patients with chronic respiratory failure receiving NPPV at home. This study included patients who were receiving NPPV at home and could handle a tablet device. The intervention group (n = 15) was exposed to an information and communications technology-based telenursing intervention program, in addition to usual care; the control group (n = 16) received the usual care only. The telenursing intervention program comprised telemonitoring and health counseling sessions via videophone. The intervention was evaluated once at enrollment and after 3 months. The primary endpoints were the number of unscheduled outpatient visits, hospitalizations, and hospital days. The secondary endpoints included the St. George’s Respiratory Questionnaire (SGRQ), Euro QOL 5 Dimension, Self-Care Agency Questionnaire (SCAQ), pulmonary function tests, and 6-minute walking distance. We found no significant differences between the intervention and control groups at enrollment. At follow-up, the number of routine outpatient visits for acute exacerbations (r = .36; p = .045), the number of hospitalizations (r = .38; p = .037), the number of hospital days (r = .39; p = .031), SGRQ (r = .36; p = .016), SCAQ (r = .41; p = .019), and 6-minute walking distance (r = .54; p = .030) were significantly different. The increase in the number of unscheduled outpatient visits in the intervention group during follow-up was attributed to acute exacerbations and a significant decrease in the number of hospitalizations and hospital days. Hence, the telenursing intervention program may be effective in reducing exacerbations in patients with chronic respiratory failure receiving NPPV at home.