Those in the control group were instructed regarding home exercises but had no planned contact with healthcare professionals. Outcome measures: Hospital admission rate and cost

of hospitalisation over a 10-month period. Results: A total of 105 participants completed the study. Over the follow-up period, the admission rate per patient was lower in the intervention group compared with GSK-3 cancer the control group (0.49 vs 1.17, p = 0.041). The cost of hospitalisations appeared to be lower in the intervention group. Conclusion: Telehealth strategies that promote rehabilitation and early detection of an acute exacerbation reduced hospital admission rates in people with severe and very severe COPD. There is considerable interest in the role of telehealth for people with COPD. A systematic review has shown that telemonitoring of physiology and symptoms reduces emergency department visits and hospitalisations (McLean et al 2011). However the use of

telehealth strategies to deliver home-based exercise training is in its infancy, despite the central role of pulmonary rehabilitation in COPD care. In the study by Dinesen and colleagues, participants who received telerehabilitation had a lower rate of hospital admission than those who received usual care. Participants had severe to very severe COPD, which reflects the group most commonly seen in pulmonary rehabilitation. However, telerehabilitation did not include supervised exercise training, and the number of contacts with clinicians during Selleckchem FG4592 the intervention period was not reported. Participants also engaged in ‘preventive self-monitoring until using a telehealth monitor’. Therefore it is difficult to assess the effect the exercise program had on reducing hospitalisations, over and above the gains expected following self-management training on this outcome (Effing et al 2007). This trial suggests that exercise participation can be encouraged using telemonitoring. However it remains uncertain whether telerehabilitation is as effective as best practice COPD care. Whilst it was stated

that the usual care group in this study underwent the standard regimen for rehabilitation, this consisted of once-off instruction in home exercises, which does not meet the current definition of pulmonary rehabilitation (Nici et al 2006). This trial therefore does not allow us to compare the outcomes of telerehabilitation to those of standard, highly effective, pulmonary rehabilitation programs (Lacasse et al 2006). Until such comparisons are undertaken in robust trials, telerehabilitation remains a useful second-line treatment for those with COPD who, for reasons of geography or disability, cannot undertake supervised pulmonary rehabilitation programs. “
“Summary of: Salisbury C, et al (2013) Effectiveness of PhysioDirect telephone assessment and advice services for patients with musculoskeletal problems: pragmatic randomized controlled trial. BMJ 346: f43. doi:10.1136/bmj.f43. [Prepared by Nicholas Taylor, CAP Co-ordinator.