Abstract
Background Our aim was to investigate the effectiveness of virtual wards on health outcomes in patients with acute respiratory infection.
Methods We searched four electronic databases from January 2000–March 2021 for randomised controlled trials (RCTs). We included studies in people with acute respiratory illness or an acute exacerbation of a chronic respiratory illness, where a patient or carer measured vital signs (oximetry, blood pressure, pulse) for initial diagnosis and/or asynchronous monitoring, in a person living in private housing or a care home. We performed random effects meta-analysis for mortality.
Results We reviewed 5834 abstracts, 107 full texts, and judged nine RCTs relevant for inclusion in which sample sizes ranged from 37–389 (total=1627), mean ages between 61 and 77 years, and five judged to be at low risk of bias. Five RCTs had fewer hospital admissions in the intervention (monitoring) group, out of which two studies reported a significant difference. Two studies reported more admissions in the intervention group, with one reporting a significant difference. We were unable to perform a meta-analysis on healthcare utilisation and hospitalisation data due to lack of outcome definition in the primary studies and variable outcome measurements. We judged two studies to be at low risk of bias. The pooled summary risk ratio for mortality was 0.90 (95% CI 0.55 to 1.48).
Conclusion The limited literature for remote monitoring of vital signs in acute respiratory illness provides weak evidence that these interventions have a variable impact on hospitalisations and healthcare utilisation, and may reduce mortality.
Methods We searched four electronic databases from January 2000–March 2021 for randomised controlled trials (RCTs). We included studies in people with acute respiratory illness or an acute exacerbation of a chronic respiratory illness, where a patient or carer measured vital signs (oximetry, blood pressure, pulse) for initial diagnosis and/or asynchronous monitoring, in a person living in private housing or a care home. We performed random effects meta-analysis for mortality.
Results We reviewed 5834 abstracts, 107 full texts, and judged nine RCTs relevant for inclusion in which sample sizes ranged from 37–389 (total=1627), mean ages between 61 and 77 years, and five judged to be at low risk of bias. Five RCTs had fewer hospital admissions in the intervention (monitoring) group, out of which two studies reported a significant difference. Two studies reported more admissions in the intervention group, with one reporting a significant difference. We were unable to perform a meta-analysis on healthcare utilisation and hospitalisation data due to lack of outcome definition in the primary studies and variable outcome measurements. We judged two studies to be at low risk of bias. The pooled summary risk ratio for mortality was 0.90 (95% CI 0.55 to 1.48).
Conclusion The limited literature for remote monitoring of vital signs in acute respiratory illness provides weak evidence that these interventions have a variable impact on hospitalisations and healthcare utilisation, and may reduce mortality.
| Original language | English |
|---|---|
| Article number | 00393-2022 |
| Journal | ERJ Open Research |
| Volume | 9 |
| Issue number | 2 |
| Early online date | 2 Feb 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 2 Feb 2023 |
Bibliographical note
Funding Information:Support statement: This review was supported by NHS Bristol, North Somerset and South Gloucestershire (CCG RCF20/21-1SC, £39 347 from 7 September 2020). Funding information for this article has been deposited with the Crossref Funder Registry.
Publisher Copyright:
© The authors 2023.