Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: A qualitative study embedded in a randomized controlled trial

TELESCOT Programme Team, Peter Fairbrother, Hilary Pinnock*, Janet Hanley, Lucy McCloughan, Aziz Sheikh, Claudia Pagliari, Brian McKinstry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To explore patient and professional views on self-management in the context of telemonitoring in chronic obstructive pulmonary disease (COPD).

Methods: Semi-structured interviews with patients with COPD and healthcare professionals participating in a randomized controlled trial of telemonitoring in Lothian, Scotland, explored experiences of using telemonitoring, and dynamics in patient-practitioner relationships. Transcribed data were analyzed using the Framework approach.

Results: 38 patients (mean age 67.5 years) and 32 professionals provided 70 interviews. Patients considered that telemonitoring empowered self-management by enhancing their understanding of COPD and providing additional justification for their decisions to adjust treatment or seek professional advice. Professionals discussed telemonitoring as promoting compliance with medical advice and encouraged patients to exercise personal responsibility within clinical parameters, but expressed concerns about promoting the sick role and creating dependence on telemonitoring.

Conclusion: Telemonitoring assisted many patients to embrace greater responsibility for their health but the model of service provision remained clinician-centered. A medical model of 'compliant self-management' may paradoxically have promoted dependence on professionals.

Practice implications: Patients and professionals shared responsibility for meeting the central objective of prompt management of exacerbations of COPD. Care is needed, however, to minimize the risk in some patients, of telemonitoring increasing dependence on practitioner support. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)403-410
Number of pages8
JournalPatient Education and Counseling
Volume93
Issue number3
DOIs
Publication statusPublished - 4 May 2013

Keywords

  • COPD
  • Primary health care
  • Qualitative research
  • Self-management
  • Telemonitoring
  • TELEHEALTHCARE
  • PERSPECTIVE
  • EMPOWERMENT
  • PARADIGM
  • TELECARE
  • IMPACT
  • TERM
  • CARE

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