The Impact of Telehealth on Quality of Care in the Management of COPD for the Adult Patient Population

Abstract

Purpose: The present integrative literature review examined whether the incorporation of TH into the management of COPD significantly/positively impacted the Quality of Life (QoL) of participating patients.

Background: Telehealth (TH) provides healthcare services remotely enabling care access for individuals facing geographic or physical barriers to in-person evaluation and follow up helping to promote optimal patient outcomes. The emergence and popularity of TM resources became evident during the COVID-19 pandemic. Numerous recent studies detailing the incorporation of TM into best practice models validates the importance of further investigation to evaluate its place in shaping the future of the healthcare industry and management of chronic disease states.

Methods: A systematic literature search was conducted utilizing the PubMed, Cochrane, and CINAHL databases. The preliminary search of Randomized Controlled Trials (RCTs) employed keywords pertinent to the review’s purpose. Established criteria then vetted articles for inclusion/exclusion enabling a manual review of abstracts. Articles deemed appropriate by two or more of the review’s authors were incorporated for analysis. A matrix of RCT components allowed for a comparison/evaluation of significant/non-significant findings.

Results: After thorough vetting, 10 RCTs were selected for review. Five trials showed statistically significant differences between the intervention and control groups. Significant differences included adherence to pulmonary rehabilitation program (1), improvement in COPD Assessment Test (CAT) scores (3), and hospital readmission rates (1).

Conclusion: Interventions including only TH monitoring failed to produce significant benefits and revealed higher rates of participant attrition. Successful interventions incorporated an established pulmonary rehabilitation component, an element to ensure accountability of adherence, and/or provided an option for two-way communication with a medical provider. Future TM interventions must engage the patient to produce positive
health outcomes effectively and significantly.

Keywords: Telehealth, Telemedicine, COPD, Quality of Care, Health Outcomes, and Adults >18 Years

Presentation

Biography

Joshua Smith, BSN, RN

Joshua Smith BSN, RN graduated from the University of North Carolina at Greensboro with a bachelor’s in biology and in nursing within the summers of 2013 and 2015 respectively. Throughout his nursing education, Smith has had a passion and interest for critical care medicine. He have been a critical care nurse for eight years within the Cone Health System. His current role is a Rapid Response and Intensive Care Charge nurse for Cone Health at Wesley Long Hospital. Within this position and through my experiences as a critical nurse, he decided to enroll at the University of North Carolina at Charlotte to pursue the Adult Gerontological Acute Care Nurse Practitioner (AGACNP) program. His goal is to become an AGACNP to further my knowledge within critical care medicine so that he can provide advanced holistic care to the adult and older adult populations throughout our communities.

Malena Wenning, BSN, RN

Malena Wenning, BSN, RN graduated in 2019 from the University of North Carolina at Charlotte and began as a new graduate nurse in the Neonatal Intensive Care Unit at Levine Children’s Hospital in Charlotte, NC. During hertime as a NICU nurse, she had the pleasure of working with families in
the intensive care setting, and have developed a passion for educating parents to care for their fragile neonates. This experience led her to pursue graduate studies at University of North Carolina at Charlotte in the Family Nurse Practitioner concentration. Her expected graduation is August of 2024, and she hopes upon graduation to work in a primary care setting where she can empower patients to meet their health goals. 

Libby Fox, BSN,RN

Libby Fox, BSN. RN graduated with aBachelor of Science in nursing from Ball State University in Muncie, Indiana in 2016. Since then, Fox has worked as a registered nurse in the inpatient care setting, serving ortho/neuro, renal/oncology, and med/surg patient populations. She worked the first year of my career at Community Hospital Anderson in Anderson, Indiana. In 2017, Fox moved to North Carolina and began my employment at Iredell Memorial Hospital in Statesville, where she is presently employed. She served as a travel nurse at Lewis Gale Medical Center in Roanoke, Virginia from January to April of 2022 before beginning the Family Nurse Practitioner program at UNC Charlotte in the fall of that year. Fox will graduate with her Master of Science in nursing (FNP concentration) in August 2024. Upon completion, she hope to serve her community in a rural outpatient clinic near her home in Harmony, North Carolina.

Christian Smith, BSN, RN

Christian Smith, BSN, RN graduated from the University of North Carolina at Greensboro with a bachelor’s in biology and in nursing within the summers of 2013 and 2015 respectively. Throughout his nursing education, he has had a passion and interest for critical care medicine. Smith has been a critical care nurse for eight years within the Cone Health System. His current role isa Rapid Response and Intensive Care Charge nurse for Cone Health at Wesley Long Hospital. Within this position and through his experiences as a critical nurse, Smith decided to enroll at the University of North Carolina at Charlotte to pursue the Adult Gerontological Acute Care Nurse Practitioner (AGACNP) program. Smith’s goal is to become an AGACNP to further his knowledge within critical care medicine so that he can provide advanced holistic care to the adult and older adult populations throughout our communities.

Mr. Matthew Williams BSN, RN, CCRN

Mr. Matthew Williams BSN, RN, CCRN (Alumnus) is a current graduate student at the University of North Carolina at Charlotte pursuing a Master of Science in Nursing focusing on the care of adult populations in an acute care setting.  Matthew currently works on the Dickson Heart Intensive Care Unit at Atrium Health Main following his passion for cardiology building upon previous experiences on the Cardiothoracic Intensive Care Unit and
with Sanger Heart & Vascular Institute’s cardiac electrophysiology (EP) team.  Prior to his entrance into the nursing profession, Matthew enjoyed a ten-year career as an environmental consultant working with agencies such as the Environmental Protection Agency (EPA), Nuclear Regulatory Commission (NRC), and Army Corps of Engineers following a degree from Gettysburg College in environmental studies.  His past and present pursuits cultivate a desire to incorporate the most current research into the most valid and beneficial best practice models ensuring positive patient outcomes and experiences.    

Cathy Horne BSN, RN

Cathy Horne BSN, RN is a graduate student at the University of North Carolina at Charlotte, pursuing a Master of Science in Nursing with a focus on the Family Nurse Practitioner program. Her nursing journey began in 2016 where she worked in various healthcare roles, including home health, medical-
surgical float, and currently as a primary RN in hospice care. Currently, she has the privilege of caring for a dedicated group of patients, conducting assessments, managing medications, and providing essential symptom control. This experience has been profoundly moving, as she becomes deeply invested in supporting patients and their families during such a sensitive and crucial time. Post-graduation, Horne’s goal is to continue to contribute to the local community, ensuring quality patient care by incorporating evidence-based practice and promoting positive healthcare outcomes.

Faculty Committee Advisor(s)

Florence Okoro, Ph.D., RN