Telehealth 'not effective' for people with long-term conditions, study finds: Department of Health's whole systems demonstrator research calls into question degree of enthusiasm for the technology.
Expectations of the benefits of telehealth technology may be scaled back after a study found it was "not effective" in improving the quality of life of people with long-term conditions.
The research, the latest findings to emerge from the Department of Health's whole system demonstrator (WSD) evaluation of telehealth and telecare, the world's biggest trial of the technology, calls into question the degree of official enthusiasm for its adoption.
Telehealth has been seen as a potential breakthrough in the care and support of more than 15 million people living with long-term conditions, who account for half all GP appointments and three-quarters of hospital bed use. By helping them better manage their conditions at home, it is expected to reduce their demands on health services.
However, the research – conducted over 12 months among 1,500 patients with lung disease, diabetes or heart failure in Cornwall, Kent and London – found that telehealth use had no impact on generic quality of life anxiety or depressive symptoms.
Writing for the British Medical Journal on bmj.com, the study team concludes: "Our findings strongly suggest no net benefit from telehealth; therefore, it should not be used as a tool to improve health-related quality of life or psychological outcomes."
The stark assessment is based on the use of telehealth to monitor the patients' vital signs up to five days a week. Individuals measured their own blood pressure, blood glucose levels or other indicator and transmitted the results to health professionals via a remote data monitoring centre.
The researchers, drawn from a group of UK universities led by City University's school of health sciences, acknowledge that their analysis ended in December 2010 and did not embrace later development of telehealth techniques, including real-time analysis of data by doctors or nurse specialists.
The study team admits also that its work did not assess any potential benefits specific to individual long-term conditions, as opposed to general wellbeing.
Previous, positive headline findings from the WSD have been used by ministers to justify expansion of telehealth and telecare provision in England. These findings included a 45% reduction in mortality rates among people using the technology, a 20% cut in emergency hospital admissions and a 15% reduction in A&E attendances.
A Department of Health spokesperson said of the previous findings from the study: "We funded a three-year randomised control trial involving more than 6,000 people, which clearly demonstrated that if implemented appropriately, telehealth can reduce emergency admissions by 20%, A&E attendance by 15% and mortality rates by 45%.
"This trial has been used to help inform the 3millionlives initiative, which aims to help improve lives through better integrated telehealth and telecare services in the next five years."
David Cameron said in December 2011: "We've trialled it, it's been a huge success, and now we're on a drive to roll this out nationwide."
Academics involved in the research have been warning that the detailed WSD results would be much more nuanced than the early headlines. Further analysis is due out next month.
Under the 3millionlives programme, launched by the prime minister, the health department intends to extend telehealth and telecare to at least three million people. Seven initial pathfinder sites across England have each committed to engage 10,000 more patients, though progress on this has been slow since it was announced last November. Guardian Professional.
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Expectations of the benefits of telehealth technology may be scaled back after a study found it was "not effective" in improving the quality of life of people with long-term conditions.
The research, the latest findings to emerge from the Department of Health's whole system demonstrator (WSD) evaluation of telehealth and telecare, the world's biggest trial of the technology, calls into question the degree of official enthusiasm for its adoption.
Telehealth has been seen as a potential breakthrough in the care and support of more than 15 million people living with long-term conditions, who account for half all GP appointments and three-quarters of hospital bed use. By helping them better manage their conditions at home, it is expected to reduce their demands on health services.
However, the research – conducted over 12 months among 1,500 patients with lung disease, diabetes or heart failure in Cornwall, Kent and London – found that telehealth use had no impact on generic quality of life anxiety or depressive symptoms.
Writing for the British Medical Journal on bmj.com, the study team concludes: "Our findings strongly suggest no net benefit from telehealth; therefore, it should not be used as a tool to improve health-related quality of life or psychological outcomes."
The stark assessment is based on the use of telehealth to monitor the patients' vital signs up to five days a week. Individuals measured their own blood pressure, blood glucose levels or other indicator and transmitted the results to health professionals via a remote data monitoring centre.
The researchers, drawn from a group of UK universities led by City University's school of health sciences, acknowledge that their analysis ended in December 2010 and did not embrace later development of telehealth techniques, including real-time analysis of data by doctors or nurse specialists.
The study team admits also that its work did not assess any potential benefits specific to individual long-term conditions, as opposed to general wellbeing.
Previous, positive headline findings from the WSD have been used by ministers to justify expansion of telehealth and telecare provision in England. These findings included a 45% reduction in mortality rates among people using the technology, a 20% cut in emergency hospital admissions and a 15% reduction in A&E attendances.
A Department of Health spokesperson said of the previous findings from the study: "We funded a three-year randomised control trial involving more than 6,000 people, which clearly demonstrated that if implemented appropriately, telehealth can reduce emergency admissions by 20%, A&E attendance by 15% and mortality rates by 45%.
"This trial has been used to help inform the 3millionlives initiative, which aims to help improve lives through better integrated telehealth and telecare services in the next five years."
David Cameron said in December 2011: "We've trialled it, it's been a huge success, and now we're on a drive to roll this out nationwide."
Academics involved in the research have been warning that the detailed WSD results would be much more nuanced than the early headlines. Further analysis is due out next month.
Under the 3millionlives programme, launched by the prime minister, the health department intends to extend telehealth and telecare to at least three million people. Seven initial pathfinder sites across England have each committed to engage 10,000 more patients, though progress on this has been slow since it was announced last November. Guardian Professional.
See also:
- Lives not improved by telehealth E-Health Insider
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