Accepted Manuscript Effects and barriers to deployment of telehealth wellness programs for chronic patients across 3 European countries A. Barberan-Garcia, I. Vogiatzis, H.S. Solberg, J. Vilaró, D.A. Rodríguez, H.M. Garåsen, T. Troosters, J. Garcia-Aymerich, J. Roca PII:
S0954-6111(13)00492-7
DOI:
10.1016/j.rmed.2013.12.006
Reference:
YRMED 4423
To appear in:
Respiratory Medicine
Received Date: 25 September 2013 Revised Date:
12 December 2013
Accepted Date: 14 December 2013
Please cite this article as: Barberan-Garcia A, Vogiatzis I, Solberg H, Vilaró J, Rodríguez D, Garåsen H, Troosters T, Garcia-Aymerich J, Roca J, , Effects and barriers to deployment of telehealth wellness programs for chronic patients across 3 European countries, Respiratory Medicine (2014), doi: 10.1016/ j.rmed.2013.12.006. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Title: EFFECTS AND BARRIERS TO DEPLOYMENT OF TELEHEALTH WELLNESS PROGRAMS FOR CHRONIC PATIENTS ACROSS 3 EUROPEAN COUNTRIES
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Running title: Expert patient program enhances aerobic capacity in COPD
Authors: Barberan-Garcia A1-2-3; Vogiatzis I4; Solberg HS5; Vilaró J6; Rodríguez DA1; Garåsen HM8-9; Troosters T10, Garcia-Aymerich J11-12-13; Roca J1-2-3 and NEXES
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2-3-7
consortium.
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Affiliations: 1Hospital Clínic de Barcelona, Thorax Clinic Institute (ICT), Pulmonary Medicine Department, Respiratory Diagnostic Center, Barcelona, Catalonia; 2Institut d’Investigacions Biomèdiques August Pi i Sunyner (IDIBAPS), Universitat de Barcelona,
Barcelona,
Catalonia;
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CIBER
en
Enfermedades
Respiratorias
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(CIBERES), Bunyola, Mallorca; 41st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece; 5Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 6Facultat de Ciències de la
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Salut Blanquerna, Universitat Ramon Llull, Physiotherapy Research Group (GReFis), Barcelona, Catalonia;
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Muscle and Respiratory System Research Unit and
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Respiratory Medicine Department, IMIM-Hospital del Mar, Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Catalonia, Barcelona; 8Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; 9Department of Health and Welfare Services, City of Trondheim, Trondheim, Norway;
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Katholieke Universiteit Leuven,
Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium;
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Centre de Recerca en Epidemiologia Ambiental
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(CREAL),
Epidemiology
Department,
Barcelona,
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Catalonia;
Epidemiologia y Salud Pública (CIBERESP), Barcelona, Catalonia;
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en
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Department of
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Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia.
Institutional addresses:
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Anael Barberan-Garcia (corresponding author):
Hospital Clínic de Barcelona. ICT. Respiratory Diagnostic Center
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170 Villarroel; 08036 Barcelona, Catalonia. Phone: (34) 932·275·540; Fax: (34) 932·275·455
[email protected]
Ioannis Vogiatzis:
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Thorax Foundation
3 Ploutarhou Str, 10675, Kolonaki, Athens, Greece.
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[email protected]
Hilde Strøm Solberg:
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Norwegian University of Science and Technology Øya Helsehus*153.003.009 Håkon Jarls gate 11; Trondheim, Norway.
[email protected]
Jordi Vilaró: Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull 326-332 Padilla; 08025 Barcelona, Catalonia.
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[email protected]
Diego Agustín Rodríguez:
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IMIM-Hospital del Mar 88 Dr. Aiguader; 08003 Barcelona, Catalonia.
Helge Magne Garåsen:
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Norwegian University of Science and Technology
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[email protected]
Øya Helsehus*153.003.009 Håkon Jarls gate 11; Trondheim, Norway.
[email protected]
Thierry Troosters:
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Respiratory Rehabilitation and Respiratory Division
UZ Gasthuisberg, Herestraat 49 bus 706, Onderwijs & Navorsing I, Labo Pneumologie; Leuven B-3000, Belgium
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[email protected]
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Judith Garcia-Aymerich:
Centre de Recerca en Epidemiologia Ambiental (CREAL), Epidemiology Department 88 Dr. Aiguader, 08003 Barcelona, Catalonia.
[email protected]
Josep Roca: Hospital Clínic de Barcelona
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170 Villarroel; 08036; Barcelona, Catalonia.
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EP
TE D
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[email protected]
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ABSTRACT
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Background: Benefits of cardiopulmonary rehabilitation (CPR) in patients with chronic obstructive pulmonary disease (COPD) are well established, but longterm sustainability of training-induced effects and its translation into healthy lifestyles are unsolved issues. It is hypothesized that Integrated Care Services supported by Information and Communication Technologies (ICS-ICT) can overcome such limitations. In the current study, we explored 3 ICS-ICT deployment experiences conducted in Barcelona, Trondheim and Athens.
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Methods: In the 3 sites, a total of 154 patients completed an 8-week supervised CPR program. Thereafter, they were allocated either to an ICS-ICT group or to usual care (CPR+UC) during a follow-up period of at least 12 months with assessment of 6-minute walking test (6MWT) as main outcome variable at all time points in the 3 sites. Because real deployment was prioritized, the interventions were adapted to site heterogeneities.
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Results: In the ICS-ICT group from Barcelona (n=77), the use of the personal health folder (PHF) was the cornerstone technological tool to empower COPD patients for self-management showing high applicability and user-acceptance. Long-term sustainability of training-induced increase in exercise capacity was observed in ICS-ICT compared to the control group (p=0.01). Likewise, ICS-ICT enhanced the activities domain of the SGRQ (p
