Abstract
Remote patient monitoring should reduce mortality rates, improve care, and reduce costs. We present an overview of the available technologies for the remote monitoring of chronic obstructive pulmonary disease (COPD) patients, together with the most important medical information regarding COPD in a language that is adapted for engineers. Our aim is to bridge the gap between the technical and medical worlds and to facilitate and motivate future research in the field. We also present a justification, motivation, and explanation of how to monitor the most important parameters for COPD patients, together with pointers for the challenges that remain. Additionally, we propose and justify the importance of electrocardiograms (ECGs) and the arterial carbon dioxide partial pressure (PaCO2) as two crucial physiological parameters that have not been used so far to any great extent in the monitoring of COPD patients. We cover four possibilities for the remote monitoring of COPD patients: continuous monitoring during normal daily activities for the prediction and early detection of exacerbations and life-threatening events, monitoring during the home treatment of mild exacerbations, monitoring oxygen therapy applications, and monitoring exercise. We also present and discuss the current approaches to decision support at remote locations and list the normal and pathological values/ranges for all the relevant physiological parameters. The paper concludes with our insights into the future developments and remaining challenges for improvements to continuous remote monitoring systems.Graphical abstractᅟ
Highlights
According to the World Health Organization (WHO) [1], chronic obstructive pulmonary disease (COPD) is currently the fourth, and will soon become the third, most frequent cause of death worldwide
COPD is a chronic and progressive respiratory disease for which there is no cure for the cause of the disease, but there are a number of therapeutic approaches for relieving the symptoms and slowing the progression of the disease
How can we make the system for the remote monitoring of COPD patients easy to use and able to adapt to each patient’s specific needs? A recent systematic review [20] shows that patients were Bgenerally satisfied and found the systems useful to help them manage their disease and improve healthcare provision.^ The review, indicates a number of usability problems that need to be overcome in future research
Summary
According to the World Health Organization (WHO) [1], chronic obstructive pulmonary disease (COPD) is currently the fourth, and will soon become the third, most frequent cause of death worldwide. The evidence for telehealthcare’s effectiveness is mixed and not conclusive, but the studies in general show an improvement or at least an equivalence with the standard care, without differences in mortality rates (except for the review by Polisena et al [18], which showed higher mortality rates in the Btelephone-support^ group). These studies of telehealthcare focus mostly on the use of communication technologies, like telephone and internet, to communicate with healthcare professionals from home, instead of the usual face-to-face care, whereas the physiological data and symptom self-reporting are transmitted and analyzed on a daily basis. There are currently specific scientific and technological challenges for the continuous remote monitoring of the PtcCO2 and ECG, which will be discussed and explained in the continuation
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