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City's Health Services Research Group publishes telehealth paper in the British Medical Journal (BMJ)

Whole Systems Demonstrator Evaluation team led by Professor Stanton Newman questions efficacy of home-based telehealth.
by John Stevenson

A telehealth paper based on a study carried out by City University London's Health Services Research Group (HSRG) has been published in the prestigious British Medical Journal.

The research group is led by principal investigator, Professor Stanton Newman, who is also the Dean of the School of Health Sciences. The team working on the research project at City consists of Martin Cartwright, Shashi Hirani, Lorna Rixon and Michelle Beynon. The study assesses home based telehealth as implemented in the HSRG's Whole Systems Demonstrator Evaluation.

nullProfessor Newman's Whole Systems Demonstrator Evaluation comprises a pragmatic, cluster randomised controlled trial of telehealth for service users with long term conditions (chronic obstructive pulmonary disease, diabetes, heart failure; known as the WSD telehealth trial) and an equivalent trial of telecare for service users with social care needs (the WSD telecare trial).

The paper concludes that second generation, home based telehealth as implemented in the Whole Systems Demonstrator Evaluation was not effective or efficacious compared with usual care in improving quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease, diabetes, or heart failure over twelve months. The findings suggest, however, that concerns about the potentially deleterious effect of telehealth on quality of life are unfounded for most patients.

Telehealth enables the remote exchange of data between a patient and healthcare professionals to facilitate diagnosis, monitoring, and management of long term conditions. Some telehealth systems incorporate an educational component aimed at improving patient knowledge and self care (for example, treatment adherence). Telehealth systems that send physiological or symptom data to a remote monitoring centre can alert healthcare professionals when disease-specific clinical parameters are breached. Thus, telehealth affords the opportunity for earlier intervention, which may reduce the frequency with which expensive hospital based care is required.

Professor Newman says there is a need for more research to understand effects of telehealth on patient self care behaviours and outcomes other than Quality of Life:

"More research is required to understand the many potential beneficial and possible negative effects by which telehealth could affect patient reported outcomes. However, our findings strongly suggest no net benefit from telehealth; therefore, it should not be used as a tool to improve health related quality of life or psychological outcomes."

To read the entire BMJ research paper, please click here.

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