Telemedicine comparable to standard care in managing CF: Study
Adherence to treatment regimens, patient satisfaction improved significantly
Telemedicine programs for managing cystic fibrosis (CF) were at least as effective as standard in-clinic care, according to a review study.
Adhering to treatment regimens and patient satisfaction with telemedicine improved significantly across most studies examined, and most participants favored continuing with telemedicine.
The review study, “Telerehabilitation and telemonitoring interventions programs used to improving quality of life in people with cystic fibrosis: A systematic review,” was published in Digital Health.
CF is a genetic disease marked by a wide range of symptoms, including shortness of breath, lung infections, digestive problems, and reproduction issues. As a result, people with CF frequently make clinic or hospital visits and require a multidisciplinary team of healthcare professionals to help manage their disease. Telehealth and telerehabilitation have been increasingly used as an alternative to in-clinic visits due to limitations caused by the COVID-19 pandemic.
Effectiveness of telemedicine vs. standard care
To understand their impact on managing CF, researchers in Spain reviewed 11 studies that focused on quality of life, lung function, and physical abilities. The studies included 664 participants, ages 5-47, with treatment durations that ranged from two months to 4.5 years. Many of them compared standard care, or no intervention, with various telehealth and/or telerehabilitation programs.
Telerehabilitation programs included phone applications to improve effectiveness in self-management skills, online video chats with members of a multidisciplinary team, and regular phone calls. Telemedicine involved in-home monitoring of overall health and lung function.
Quality of life was assessed using the Cystic Fibrosis Questionnaire (CFQ) and the SF-36 Questionnaire, as well as EQ-5D-5L or EQ-5D-Y-5L for adolescents. No significant changes were seen in quality of life from data obtained before and after the studies, but two studies found significant quality of life improvement, either overall, or in social functioning and vitality.
Lung function showed significant improvements with telehealth in one of four studies. A study that compared a group that had exacerbations, when symptoms suddenly worsen, with a group that didn’t found the combination of lung function tests and Respiratory Symptom Score could predict an exacerbation with an accuracy of 92.9%.
Only one study investigated physical abilities as assessed with the six-minute walking tests, which measures the distance walked in six minutes, and didn’t show significant differences. While muscle strength also significantly improved in this study, there were no changes in lung function or exercise capacity, as measured by the oxygen consumption rate (V02).
Treatment adherence improved significantly in most studies, which researchers attributed to the ease of reporting and the use of modern technology. Data recorded in mobile applications was able to detect exacerbations quickly.
All four studies that examined patients’ satisfaction with telehealth and/or telerehabilitation programs reported positive results. A total of 80% of participants wanted to continue using this method in the future. In-home monitoring was deemed helpful for physicians and reduced their workload in CF centers.
“This systematic review supports that telemedicine program could be considered at least as effective as conventional health and more effective than no intervention in improving respiratory symptoms and quality of life in patients with cystic fibrosis,” the researchers wrote. “With regard to adherence and participant satisfaction with telemedicine, the vast majority of studies show significant results in favor of continuing with this method in the future.”