Background Non-invasive ventilation (NIV) is an established treatment for chronic hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD). Adherence to NIV remains a major challenge in the homecare setting. Telemedicine (TM) concepts are evolving rapidly and may impact therapy adherence, and subjective outcomes. Methods In this prospective randomized controlled trial, 54 NIV-naïve patients with chronic hypercapnic COPD received a modem-equipped home NIV for 1 year. The standard care group (SC) followed German guidelines that recommended up to 3 hospital control visits, the telemedicine care group (TC) was provided with a smartphone application for self-monitoring and feedback and received tailored expert interventions based on a traffic light system. Primary objectives were daily NIV adherence, secondary objective was quality of life (QoL). Results The TC group used 5.5 h·day −1 , the SC group used 4.0 h·day −1 (p=0.068), with a significant drop after the first visit (p=0.004). QoL changed in the TC group (CAT Δ −3.1, p=0.01; SGRQ Δ −7.7, p=0.002). A total of 195 tele-interventions were conducted, mainly for therapy re-engagement and mask problems. The app was well accepted and used regularly. Conclusions This multimodal telemedicine mHealth concept was feasible but did not reach statistical significance in the primary endpoint, while it was associated with improved QoL in an exploratory secondary analysis. As the intervention combined telemonitoring with structured clinical feedback and proactive contacts, attribution to a single component is limited. Larger powered studies are needed to confirm effects on adherence and clinical outcomes and to identify which programme elements drive benefit.
Richter et al. (Thu,) studied this question.
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