Telehealth for healthcare delivery in adults with bronchiectasis: A systematic review

BackgroundThis systematic review examined the feasibility and clinical effectiveness of telehealth in adults with bronchiectasis.MethodsFive electronic databases were searched for telehealth interventions in adults with bronchiectasis. Feasibility and clinical effects data were extracted. Best evidence synthesis was reported as effect size (d), 95% confidence interval (CI).ResultsNine studies were included (n=156 participants). Interventions were pulmonary rehabilitation (n=4 studies), physical activity promotion (n=1 study), airway clearance therapy (n=3 studies), and multidisciplinary treatment (n=1 study). Studies reported high adherence to interventions (73-100%), high patient satisfaction (81-100%), and minor adverse events with selected interventions. Telehealth pulmonary rehabilitation (4 studies; 21 participants) demonstrated improvements in health-related quality of life (HRQOL) with small to large effect sizes at end-intervention (Chronic Respiratory Questionnaire domains: d range 0.23 to 1.78) but mixed effects on psychological symptoms (d range -1.12 to 0.04). Telehealth airway clearance therapy improved HRQOL (St Georges Respiratory Questionnaire total score: mean difference -5.8 [95% CI -10.8 to -0.9]).ConclusionsTelehealth pulmonary rehabilitation and airway clearance interventions are low risk, feasible and may be clinically effective in this population. Small sample sizes underscore the need for larger trials. Little is known about other telehealth-delivered interventions in bronchiectasis.