OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is characterized by irreversible or poorly reversible airflow obstruction in the lung. Self-management strategies are becoming more important in the treatment of COPD. In this study, the clinical effectiveness of telemonitoring for COPD was investigated.

METHODS: To conduct systematic review, we searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL up to March 2016. We selected randomized controlled trials (RCT) comparing telemonitoring group and control group for COPD. We analyzed dichotomous data as relative risk (RR), and continuous data as mean difference (MD) or standardized mean differences (SMD) while using random-effects models. Critical outcomes were COPD exacerbation, quality of life or health status and all-cause mortality.

RESULTS: Twenty four RCTs were included. As a result of meta-analysis, there were no variables showing statistically significant results between two groups. Exacerbation rate (6 studies) was not different between two groups (RR 0.67, 95% CI 0.31 ~ 1.42). Due to the moderate degree of the heterogeneity among studies (I= 67%), subgroup analysis was performed. Intervention period could be the one of the factors describing the heterogeneity. No difference between group was found for exacerbation period (6 studies; MD 0.12, 95% CI –1.18 ~ 1.43) and number of exacerbations (6 studies; MD -0.76, 95% CI –0.32 ~ 0.07). Also quality of life (10 studies) did not show any difference between the two groups (SMD -0.17, 95% CI –0.41 ~ 0.07). Finally, mortality (5 studies) was not different between the two groups (RR 0.80, 95% CI 0.48 ~ 1.35).

CONCLUSIONS: The use of telemonitoring for COPD was unlikely to result in statistically significant improvements in health outcomes. However, in the subgroup analysis, telemonitoring longer than 6 months reduced the exacerbation rates. To clarify the effects of telemonitoring for COPD, further researches are needed with the well-defined intervention and outcome variables.