Chronic Obstructive Pulmonary Disease Patients' Acceptance in E-Health Clinical Trials

Saeed M Alghamdi; Ahmed M Al Rajah; Yousef S Aldabayan; Abdulelah M Aldhahir; Jaber S Alqahtani; Abdulaziz A Alzahrani

doi:10.3390/ijerph18105230

Chronic Obstructive Pulmonary Disease Patients' Acceptance in E-Health Clinical Trials

Int J Environ Res Public Health. 2021 May 14;18(10):5230. doi: 10.3390/ijerph18105230.

Authors

Saeed M Alghamdi^{1

2}, Ahmed M Al Rajah³, Yousef S Aldabayan³, Abdulelah M Aldhahir⁴, Jaber S Alqahtani^{5

6}, Abdulaziz A Alzahrani^{1

7}

Affiliations

¹ Department of Respiratory Care, College of Applied Health Science, Umm Al Qura University, Makkah 21955, Saudi Arabia.
² National Heart and Lung Institute, Imperial College London, London SW3 6NP, UK.
³ Respiratory Care Department, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
⁴ Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia.
⁵ UCL Respiratory, University College London, London WC1E 6BT, UK.
⁶ Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia.
⁷ Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK.

Abstract

Introduction: Telehealth (TH) interventions with Chronic Obstructive Pulmonary Disease (COPD) management were introduced in the literature more than 20 years ago with different labeling, but there was no summary for the overall acceptance and dropout rates as well as associated variables.

Objective: This review aims to summarize the acceptance and dropout rates used in TH interventions and identify to what extent clinical settings, sociodemographic factors, and intervention factors might impact the overall acceptance and completion rates of TH interventions.

Methods: We conducted a systematic search up to April 2021 on CINAHL, PubMed, MEDLINE (Ovid), Cochrane, Web of Sciences, and Embase to retrieve randomized and non-randomized control trials that provide TH interventions alone or accompanied with other interventions to individuals with COPD.

Results: Twenty-seven studies met the inclusion criteria. Overall, the unweighted average of acceptance and dropout rates for all included studies were 80% and 19%, respectively. A meta-analysis on the pooled difference between the acceptance rates and dropout rates (weighted by the sample size) revealed a significant difference in acceptance and dropout rates among all TH interventions 51% (95% CI 49% to 52; p < 0.001) and 63% (95% CI 60% to 67; p < 0.001), respectively. Analysis revealed that acceptance and dropout rates can be impacted by trial-related, sociodemographic, and intervention-related variables. The most common reasons for dropouts were technical difficulties (33%), followed by complicated system (31%).

Conclusions: Current TH COPD interventions have a pooled acceptance rate of 51%, but this is accompanied by a high dropout rate of 63%. Acceptance and dropout levels in TH clinical trials can be affected by sociodemographic and intervention-related factors. This knowledge enlightens designs for well-accepted future TH clinical trials. PROSPERO registration number CRD4201707854.

Keywords: COPD; chronic obstructive pulmonary disease; meta-analysis; systematic review; telehealth.

Publication types

Meta-Analysis
Review

MeSH terms

Humans
Pulmonary Disease, Chronic Obstructive* / therapy
Telemedicine*