NURS FPX 9902 Assessment 3 Literature Synthesis

NURS FPX 9902 Assessment 3 Literature Synthesis

Literature Synthesis

Understanding the necessity for therapies to manage chronic obstructive pulmonary disease (COPD) depends heavily on literature synthesis. Literature synthesis provides healthcare practitioners with a thorough understanding of the efficacy of treatments like nutritional assistance and telemedicine by methodically evaluating and assessing previous studies. Literature synthesis aids in identifying the most promising methods to enhance lung function and lower readmissions since COPD is a complicated illness requiring various therapies. The literature will be analyzed and synthesized to address the problem of COPD and evaluate different approaches present in the PICOT question which is as follows: 

“In patients diagnosed with COPD (P), how do nutritional and telehealth interventions

(I) compared to standard care without nutritional and telehealth interventions improve lung functioning and reduced readmission (O) in the time period of 2 to 3 months (T)”?

It is feasible to assess the overall effectiveness of these therapies and identify knowledge gaps that need more research by combining data from several studies. Additionally, literature synthesis offers a solid basis for evidence-based practice, empowering medical professionals to make wise choices and provide COPD patients with the best treatment possible (Ahmadi et al., 2020).

Literature Search Strategy

A thorough literature search method was used to research the PICOT issue regarding interventions for COPD. Relevant keywords included in the search phrases were “COPD,” “chronic obstructive pulmonary disease,” “nutritional interventions,” “telehealth interventions,” “lung function,” “readmission,” and “standard care”. Boolean operators like “AND” and “OR” were used to combine these phrases to narrow the search. MeSH, or medical topic headings, strengthened the search method even further. To find research indexed with these particular criteria in medical databases, MeSH terms like “Pulmonary Disease”, “Chronic Obstructive,” “Nutritional Support,” and “Telemedicine” were included. To find relevant publications from the reference lists of included studies and systematic reviews, manual searches were carried out in addition to scanning electronic databases, including PubMed, MEDLINE, and Embase. This additional effort facilitated the screening of new sources that may have been inadvertently missed during the original search process (Chahdi et al., 2023).

The number of items discovered during the thorough search was noted, and these items comprised a mix of published research, systematic reviews, official publications, and pertinent dissertations or thesis reports. Based on predefined inclusion and exclusion criteria, these compositions were then screened. Studies that compared nutritional and telehealth therapies to standard care without these interventions and evaluated lung performance and readmission as outcomes were required to be completed within 2 to 3 months to meet the inclusion criteria. Studies that did not fit these requirements or were not in English were disqualified. After the screening procedure, 30 parts were kept for further examination (Deutz et al., 2020). These articles were chosen based on the study’s design, the strength of the evidence presented, and their applicability to the research topic. 

To guarantee a thorough grasp of the body of literature, systematic reviews were included, and the policy implications of government publications were taken into account. It was included in a dissertation or thesis report that satisfied the requirements and offered distinctive insights or viewpoints. A robust and representative body of evidence was created for the research on the PICOT question related to interventions for COPD by using a thorough literature search strategy, including various sources beyond published studies and applying strict inclusion and exclusion criteria. The final selection of 30 retained pieces was made possible by these methods (Furulund et al., 2021).

Analysis of Literature

Comparing the efficacy of dietary and telehealth therapies to that of conventional care was the subject of the study on interventions for COPD. The analysis of the literature that was kept for the research on interventions for COPD offered valuable insights into the effectiveness of these interventions. The chosen papers represented various research methodologies, such as randomized controlled trials, observational studies, systematic reviews, and official government publications. Because the retained papers provided a comprehensive understanding of the benefits, limitations, and implementation strategies associated with these therapies, they played a pivotal role in advancing the provision of care for Chronic Obstructive Pulmonary Disease (COPD) and informed evidence-based practice (Holst et al., 2019).

Investigation of Nutritional Interventions for COPD

A study by Furulund et al. (2021) provides a comprehensive study examining how various dietary therapies affect people with COPD. The review presents information on the effects of diet on pulmonary and physical function, inflammation, and health-related quality of life, it does not specifically delve into the examination of telehealth treatments. The results imply that increasing fruit and vegetable consumption over extended periods may improve lung function in people with COPD. Other dietary therapies also had some, although variable, impacts on systemic inflammation, health-related quality of life, and physical function. However, the study emphasizes the need for more studies to look at the outcomes of long-term dietary changes. The focus of the paper by Nguyen et al. (2019) was to investigate the nutritional status and food consumption patterns among outpatients in Vietnam with COPD. Although the research does not specifically address telemedicine therapies, it provides valuable insights into the nutritional condition of COPD outpatients and its correlation with health-related quality of life. The results show that malnutrition, weight loss, insufficient nutritional intake, and poor quality of life among COPD outpatients are common. According to the research, nutritional advice, such as increasing the number of meals eaten daily and emphasizing foods high in protein and energy, may aid COPD patients’ nutritional status and quality of life.

A study by Van Beers et al.’s (2020) examines the clinical result and financial viability of a 12-month dietary intervention plan in muscle-wasting COPD patients. The study offers insights into the effects of nutritional counseling and supplementation on various outcomes, including physical capacity, physical activity, enriched nutrient levels, body weight, anxiety and depression scores, and general health status, even though telehealth interventions are not explicitly mentioned. The findings show that dietary intervention enhances physical activity, general health status, and body weight but does not improve the long-term effects of exercise training on physical ability in muscle-wasted COPD patients. The publications advance knowledge of the effects of dietary treatments on people with COPD, even when they do not specifically address telehealth therapies. 

Combining nutritional assistance with telemedicine interventions in treating COPD may provide a holistic strategy for boosting lung function, lowering readmission rates, and improving overall care. Telehealth treatments make it possible for remote monitoring, instruction, and support, enabling healthcare professionals to keep track of patient’s progress, provide timely advice, and handle any issues. A better outcome for people with COPD may result from combining dietary therapies with telehealth strategies to provide individualized and ongoing care.

Nutritional Interventions in COPD Management

The effect of a high-protein oral nutritional supplement (ONS) containing Beta-hydroxy-beta-methylbutyrate (HMB) on undernourished, hospitalized older patients with COPD was the main topic of the research done by Deutz et al. in 2020. The findings demonstrated that supplementation with HP-HMB within 90 days after hospital release substantially reduced mortality risk and enhanced handgrip strength, body weight, and nutritional biomarkers. These results imply that dietary treatments may improve the health status of this patient group. In order to improve outcomes for malnourished hospitalized COPD patients, this research recommends using nutritional therapies (particularly a specialized oral nutritional supplement). The aforementioned study aligns with the “I” (intervention) component of the PICOT question and provides evidence regarding the potential benefits of dietary therapies in improving lung function and reducing readmissions within a 90-day timeframe.

Keogh and Mark Williams’ (2020) narrative review examines the effects of malnutrition on COPD and emphasizes the significance of nutrition management in clinical practice. According to the review, malnutrition has detrimental impacts on exercise, muscle and lung function, exacerbations, mortality, and expense. Furthermore, the study suggests that providing education and dietary support may lead to immediate improvements or benefits. This study offers a more comprehensive viewpoint on how to treat malnutrition in COPD patients. In order to combat malnutrition in this group, it emphasizes the necessity for educational programs and nutritional treatments. Despite not mentioning telehealth therapies directly, it highlights the significance of nutritional care, which may be included in a thorough telehealth program for COPD patients.

These trials provide insightful information on how dietary therapies affect COPD outcomes. They contend that nutritional treatments, such as proper food consumption and oral nutritional supplements, may increase physical strength, lower mortality risk, and improve quality of life. Even though telehealth therapies are not explicitly included in any of the studies, including dietary interventions in a telemedicine program might provide a holistic strategy for controlling COPD and enhancing patient outcomes. Further investigation is required to determine the precise effect of telemedicine interventions on the dietary status, pulmonary function, and readmission rates of COPD patients during a 2- to 3-month period.

Impact of Nutritional Supplements on COPD

Aldhahir et al.’s (2020) comprehensive review sought to assess the evidence in favor of using nutritional supplements during pulmonary rehabilitation (PR) in stable COPD patients. A total of 917 individuals with COPD actively participated in the evaluation, which encompassed 22 trials. The results demonstrated that most trials did not identify any significant benefits for exercise capacity when dietary supplements were added to pulmonary rehabilitation (PR). Though some studies found a considerable rise in body weight, others noted benefits in quality of life and inspiratory muscle performance. Due to the diversity of supplements, outcome measures, and PR programs, the authors concluded that insufficient evidence exists to justify using nutritional supplements for COPD patients during PR.

The goal of the research by Holst et al. (2019) was to examine the relationship between calorie and protein consumption and functional ability in COPD patients referred to community-based pulmonary rehabilitation (PR). The research, which included 79 COPD patients, discovered that the individuals had a significant frequency of inadequate intake of protein and calories. The 30-second chair stands and 6-minute walking tests, which evaluate functional ability, positively correlated with inadequate protein consumption. However, the relationship between calorie intake and functional ability was not present. The authors stressed the need to consume enough protein and calories during PR to maximize the benefits of physical exercise.

Ingadottir et al.’s (2019) feasibility experiment sought to determine the effects of oral nutritional supplements (ONS) and in-between-meal snacks on quality of life and body weight in COPD patients diagnosed as being at nutritional risk. In the experiment, hospitalized COPD patients at risk for malnutrition were randomized to receive ONS or snacks in addition to their usual meals over 12 months. Both groups gained weight, according to the research, and their quality of life increased. The authors concluded that snacks were at least as practical and successful as ONS in increasing weight and quality of life in COPD patients who were at nutritional risk. The three studies offer insights into the use of dietary therapies in COPD patients, which may be relevant to your PICOT inquiry. According to the first research by Aldhahir et al. (2020), nutritional supplements may not have substantial advantages for exercise capacity. However, they may increase body weight, inspiratory muscle function, and quality of life during pulmonary rehabilitation. This shows that dietary therapies may be able to help COPD patients in ways other than lung function. In order to maximize functional capability during pulmonary rehabilitation, the second research by Holst et al. (2019) emphasizes the need for adequate calorie and protein consumption. This conclusion is in favor of including dietary therapies in the overall care strategy for COPD patients in order to enhance lung function. Ingadottir et al.’s third investigation (2019) looks at the viability and efficacy of oral nutritional supplements and snacks in COPD patients at nutritional risk. Although telehealth therapies are not explicitly addressed in this research, it highlights the potential advantages of dietary therapy in enhancing weight and quality of life, both of which may influence lung function and readmission rates.

Combined Nutritional and Telehealth Intervention Study

The effectiveness of fortified whey beverage intake on inflammation, muscle mass, functioning, and quality of life in patients with moderate-to-severe COPD was examined by Ahmadi et al. (2020). This research directly pertains to the “nutritional interventions” component of the PICOT question. The results show that daily consumption of fortified whey enhanced skeletal muscle mass and strength, lower levels of inflammatory cytokines, and better health-related quality of life. These encouraging results imply that dietary therapies, particularly enriched whey, might improve COPD patients’ general health and muscular function.

In their systematic review, Stellefson et al. (2022) focused on telehealth and non-telehealth self-management treatments for persons with COPD in rural locations. Even though telehealth is not explicitly mentioned in the PICOT question, this research offers insightful information on COPD patients’ self-management strategies. In both telehealth and non-telehealth therapies, the review found studies that indicated increased self-management effectiveness, quality of life, exercise capacity, and awareness of COPD. This implies that telemedicine and other self-management treatments might help COPD patients in remote settings have better results.

Despite focusing on telemedicine pulmonary rehabilitation rather than nutritional therapies, the research by Bhatt et al. (2019) proves the efficiency of telehealth interventions in lowering readmission rates in COPD patients. The research showed that early implementation of a video telemedicine pulmonary rehabilitation intervention resulted in lower 30-day all-cause readmission rates after a hospital stay for a COPD exacerbation. Although the dietary component of your PICOT issue needs to be explicitly addressed in this research, it does show the potential advantages of telemedicine treatments in lowering readmission rates and enhancing outcomes for COPD patients. The research by Cristina Rezende1 et al. (2023), which looks at the effect of a telemedicine program on readmissions and death following a COPD exacerbation, directly connects to the PICOT issue. Compared to the control group, the research indicated that telemonitoring systems used during hospitalization for a COPD exacerbation resulted in a decreased incidence of death or readmission after 12 months. The results imply that telemonitoring may improve long-term outcomes for COPD patients. The research is observational. Thus, it is vital to emphasize that it cannot show a connection between telehealth intervention and better results. To verify these results, more randomized controlled studies are required.

Alghamdi and Rajeh’s (2019) systematic review focuses on the behavioral change methods (BCTs) used in COPD telehealth treatments. Although it does not explicitly address the results of lung functionality and readmission, it offers insightful information about the tactics used in telemedicine therapies. The analysis found that 16 BCTs are often utilized in telehealth treatments for COPD, with the most popular strategy being disseminating knowledge on the effects of behavior. The design of telehealth solutions may be improved, and their efficacy increased by comprehending these strategies. Telehealth treatments may significantly affect behavior modification and eventually enhance patient outcomes by integrating a mix of BCTs. The efficacy of video telehealth pulmonary rehabilitation as an alternative to center-based programs is investigated in the research by Bhatt et al. (2019). Despite not addressing dietary therapies explicitly, it is pertinent to the PICOT topic to question the effect of telemedicine therapy on lung functionality and readmission. The research discovered that video telemedicine pulmonary rehabilitation produced clinical gains comparable to center-based programs in terms of dyspnea and functional exercise tolerance. This shows that telemedicine therapies could be a good choice for people with trouble getting pulmonary rehabilitation at a facility. It is crucial to remember that this research concentrated on immediate clinical benefits and that longer-term results and program adherence need additional investigation.

The first research highlights how dietary therapies might improve individuals with COPD’s quality of life and muscle mass. The second research demonstrates how COPD patients, especially those living in remote locations, may improve various outcomes with self-management treatments, including telehealth strategies. The third research shows how telemedicine therapies, particularly telehealth pulmonary rehabilitation, can potentially lower readmission rates for COPD patients. Together, these trials show that telemedicine and dietary therapy may help COPD patients achieve better results and have fewer readmissions. By incorporating these therapies into COPD care, it may be possible to improve lung function, muscle mass, and quality of life and decrease the risk of readmission to the hospital. The combined benefits of dietary and telehealth treatments in COPD therapy within the designated time range of 2 to 3 months need more study.

Telehealth Interventions in COPD Management

A thorough analysis of home-based telehealth pulmonary rehabilitation (HTPR) programs for people with chronic obstructive pulmonary disease (COPD) is provided in the article by Michaelchuk et al. (2022). The review included a total of 38 trials, involving 1993 individuals with stable COPD. The components of the HTPR programs, such as exercise and education or exercise alone, and the form of delivery, such as synchronous virtual exercise supervision, vary. The meta-analysis showed that HTPR substantially improved dyspnea and COPD evaluation scores more than standard care and was equivalent to outpatient pulmonary rehabilitation (PR) programs. The effect on sedentary time and step count, however, was minimal. The research underscores the potential of HTPR as a successful substitute for conventional center-based PR programs while highlighting the variety in HTPR program designs.

A randomized controlled crossover experiment was carried out by Rassouli et al. in 2021 to examine the effects of standard care (SC) and telehealth care (TC) on the development of COPD illness. The TC strategy focused on the early detection of exacerbations and entailed patients responding to daily questionnaires online. According to the research findings, the utilization of telehealthcare was associated with a decrease in the rise of the COPD Assessment Test (CAT) slope. This suggests that individuals receiving Telehealth Care exhibited a slower rate of disease progression compared to those receiving standard care (SC). With TC, there was a considerable improvement in patient satisfaction with the level of treatment, and more mild exacerbations were found during TC, indicating greater diagnostic sensitivity. The research emphasizes the potential of TC in slowing the course of COPD illness and raising patient satisfaction. Telehealth approaches have garnered significant research attention in the management and treatment of COPD. In their research from 2021, Tian et al. looked at meta-analyses of telemedicine treatments from several medical specialties, including pulmonary care. The results revealed that telehealth treatments demonstrated a positive effect by reducing fatality rates. Additionally, Marcos et al.’s research from 2022 showed how a telemonitoring scheme might lower mortality or readmissions after a severe COPD exacerbation. These studies prove that telehealth therapies may help COPD patients achieve better results using fewer healthcare resources, consistent with the PICOT question’s goal of increasing lung function and lowering readmission rates.

Pedagogical-counseling strategies were sought by Chahdi et al. (2023) in order to decrease readmissions and enhance outcomes for COPD patients. The systematic literature review considered 21 studies totaling 3894 COPD patients. Self-management courses, telemedicine, and educational interventions were among the strategies that were looked at. In five out of seven trials, self-management programs showed a substantial decrease in readmissions. Across studies, the impact of telemedicine treatments on outcome metrics varied, with two citing beneficial impacts and four indicating no appreciable impact. Despite two studies showing a substantial difference in favor of the intervention group, educational interventions had mixed outcomes. In conclusion, the study emphasizes the potential of self-management programs and the need for more research on the efficiency of telemedicine and educational interventions.

The PICOT question, which examines the effect of dietary and telemedicine treatments on lung functionality and readmission rates in COPD patients, is relevant to the chosen studies. The research that examines the telehealth component of the interventions provides insights into the efficacy of home-based telehealth programs, telehealth care, and telemedicine treatments for the management of COPD. They show that telehealth interventions like home-based telehealth pulmonary rehabilitation and telehealthcare can provide comparable or superior results to conventional or standard treatment. Improvements in dyspnea, COPD assessment results, and disease progression have been shown as a result of these therapies. Programs for self-management have also been shown to significantly lower readmissions. The dietary part of treatments needs to be specifically addressed in the research, which is more concerned with telehealth. To address the PICOT topic entirely, it would be crucial to look into further research examining the effect of dietary therapies in combination with telehealth programs on lung functionality and readmission rates in COPD patients. Based on the results of this research, telehealth therapies, such as home-based telehealth pulmonary rehabilitation and telehealth care, may be included in managing COPD to help patients achieve better results.

Evaluating Effects on Quality of Life, Readmissions, and Healthcare Utilization

The Wong et al. (2022) research investigated how a nurse-led telehealth self-care promotion program affected older individuals living in the community and their quality of life (QoL). The research emphasized the potential advantages of telehealth treatments in improving patient outcomes while not focusing primarily on nutritional therapies. The results showed that telehealth treatments directed by nurses substantially positively impacted older persons’ self-efficacy, depression, and general quality of life. The research results indicate that telehealth treatments may benefit COPD management and general well-being, even if they are not directly connected to lung function and readmission. The Leonard et al. (2021) research looked at how a telemedicine intervention affected noninvasive home ventilation (NIV) in a COPD group in a rural area. The research emphasizes the potential advantages of telemedicine in remote monitoring and treating COPD, even though NIV was the main emphasis. The telemedicine intervention led to better NIV treatment adherence, which may benefit lung function and overall disease management. Healthcare professionals may monitor patient progress, see early indications of exacerbations, and provide prompt treatments by incorporating remote monitoring via telehealth interventions. Thus, remote monitoring and telemedicine may help COPD patients achieve their intended objectives of increased lung function and fewer readmissions.

The impact of post-discharge telemonitoring on 30-day COPD readmissions and death rates was examined by Hamadi et al. in 2020. This research assessed the influence of telehealth services on readmission and death rates in COPD patients without specifically addressing dietary therapy. The findings showed that those hospitals providing post-discharge telemonitoring saw an increase in readmissions but a reduction in 30-day COPD death rates. This research suggests that, despite possible difficulties linked to readmission rates, telemedicine treatments may contribute to lowering mortality and improving patient outcomes. Mohr et al. (2023) conducted a comparative efficacy-matched cohort research to assess the relationship between the start of home telehealth (HT) and healthcare use in veterans with CHF, COPD, or DM. Although dietary treatments were not a primary focus of the trial, it did examine how HT monitoring affected inpatient hospitalizations, ED visits, and death rates. The findings showed that HT start was linked to more ED visits but not a significant change in hospitalizations for individuals with CHF and DM. However, HT start was linked to more excellent all-cause death rates and higher healthcare utilization in people with COPD. This research demonstrates that the particular chronic ailment being treated may impact the efficacy of telemedicine treatments.

The studies that have been evaluated provide light on the possible advantages and difficulties of telehealth therapies in the setting of COPD. The studies show that telehealth treatments, directed by healthcare experts like nurses, may favor patient outcomes, including QoL, self-efficacy, and mortality rates, even when dietary therapies were not explicitly addressed. The need for more research to improve the design, execution, and integration of telehealth therapies in COPD therapy is highlighted by rising ED visits and inconsistent impacts on readmission rates. Including dietary therapies in telehealth programs might provide a more thorough way to meet the unique requirements of COPD patients, improve their lung function, and reduce readmission rates.

Integration of Telehealth and Nutritional Interventions for Optimal COPD Care

A comprehensive review and meta-analysis of telemedicine therapies for COPD in China were undertaken by Liu et al. (2020). The study findings demonstrated that the implementation of telemedicine significantly improved the quality of life for patients with COPD while simultaneously reducing hospitalization rates. This research proves that telehealth treatments help manage COPD, which aligns with the PICOT question’s goal of lowering readmission rates and improving lung function. The changes in plasma amino acid levels in patients with acute exacerbation of COPD (AECOPD) with and without bacterial infection are the main topic of Inoue and Ikeda’s research from 2019. The research emphasizes the significance of comprehending COPD patients’ nutritional status and metabolic changes during exacerbations, even if it does not explicitly address nutritional therapies. According to the research, certain amino acids such as asparagine, citrulline, glutamine, histidine, serine, and threonine might be used as diagnostic indicators to distinguish between bacterial and nonbacterial Acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This highlights the potential value of nutritional therapies targeted to specific disease subgroups in treating COPD. More study is required to understand how focused dietary therapies affect COPD patients’ readmission rates and lung function.

Similar to this, Cristina Rezende et al.’s scoping analysis from 2023 investigated several telehealth options for COPD patients who had been admitted to the hospital because of an exacerbation. Articles describing telehealth, telemonitoring, telemedicine, and similar ideas were included in the evaluation. The results showed that telehealth therapies and telemonitoring might enhance the quality of life while lowering the number of hospital readmissions, emergency service admissions, duration of hospital stays, and medical expenses. This analysis further proves telemedicine treatments’ efficiency in improving patient outcomes and lowering readmission rates. While most of the research by Frankfort et al. (2021) tackles the topic of post-discharge care for COPD patients, the PICOT inquiry primarily focuses on telemedicine treatments. Their ground-breaking “transition to home” approach, which consists of proactive therapies supported by a pulmonary navigator, significantly reduced readmissions. Although this research did not particularly examine nutritional therapies, it does show the need for complete interventions beyond telehealth and provides insights into the larger context of COPD therapy.

Based on the in-depth evaluation of the chosen studies, it is clear that telehealth initiatives, such as telemedicine and telemonitoring, have the potential to enhance lung function and lower readmission rates in COPD patients. Evidence of telehealth treatments’ beneficial effects on quality of life, re-hospitalization rates, and healthcare expenditures is shown in the research by Liu et al. (2020) and Cristina Rezende et al. (2023). Nutritional therapies may be included in the overall COPD care strategy for complete management, even though they were not mainly addressed in these trials. In order to further improve the outcomes for COPD patients, the research by Frankfort et al. (2021) underlines the significance of post-discharge care and proactive measures, which may include nutritional assistance. Healthcare professionals may give a comprehensive strategy for managing COPD that focuses on lung functionality, readmission rates, and general well-being by integrating telehealth treatments with dietary tactics.

Telehealth Interventions in Liver Transplantation, COPD, and Beyond

The research by Tian et al. (2021) focused on telemedicine for post-liver transplant follow-up treatment. The results may apply to your PICOT query even if the research’s main context is liver transplantation. According to the research, telemedicine-based follow-up care led to quick healing and decreased readmission rates within 30 days after discharge. The telemedicine group had shown early diagnosis and treatment of problems and decreased healthcare costs. These results suggest that telemedicine interventions may improve postoperative and follow-up care by encouraging self-care, medication adherence, and the best clinical results. Although the research focuses on liver transplantation particularly, managing COPD may also benefit from the advantages associated with using telemedicine.

The complete overview of telemedicine in the Organization for Economic Co-operation and Development (OECD) nations is provided by the umbrella study conducted by Eze et al. (2020). The review included features of telemedicine therapies’ clinical and financial efficacy, patient experience, and implementation. It was found that telemedicine interventions had positive results in several areas, including glycemic control in diabetic patients, a decline in mortality and hospitalization from chronic heart failure, pain management, an increase in physical activity, an improvement in mental health, a better diet and nutrition, and a decrease in asthma exacerbations. These results suggest that telemedicine treatments have the potential to enhance patient outcomes and health-related quality of life, which is consistent with the aim of your PICOT inquiry, which is to improve lung function and decrease readmissions in COPD patients. By compiling current meta-analyses from a range of medical specialties, including pulmonary care, the systematic review by Snoswell et al. (2021) offers an overview of the impact of telemedicine on mortality. Although the results do not specifically address how telemedicine affects lung function and readmission in COPD patients, they do add to our knowledge of the security and efficiency of telehealth. According to the research, telehealth is seen as an effective way to provide healthcare, especially for those who have trouble getting around or live in rural or isolated locations. The significant evaluation emphasizes the need to make sure that the switch from in-person to telehealth does not compromise the standard of treatment or provide subpar or hazardous results. Decision-makers may use the data from this evaluation to support and direct the introduction of telehealth treatments in managing COPD, combined with disease-specific and health-economic evidence.

A telemedicine intervention’s effects on home non-invasive ventilation (NIV) in a rural population with advanced COPD were examined in the Leonard et al. (2021) trial. Even while NIV is the main topic, the research sheds light on telemedicine’s function in addressing COPD in remote areas. Following hospitalization for COPD exacerbations, the intervention, which included a contact center, showed substantially increased device utilization and cumulative use in hours compared to the control group getting NIV alone. The results imply that telemedicine treatments may enhance medication adherence and improve outcomes in rural COPD patients, even though there was no statistically significant difference in readmission rates between the two groups. In these circumstances, telemedicine and dietary therapy may be used to improve the management of COPD. The reviewed studies show the potential advantages of telehealth therapies, such as telemedicine, in enhancing outcomes for COPD patients. The Tian et al. (2021) research proves lower readmission rates and better recovery in a patient cohort after liver transplantation. Eze et al.’s comprehensive evaluation from 2020 affirms the beneficial effects of telemedicine treatments on numerous facets of patient care and outcomes. The research by Leonard et al. (2021) also illustrates the potential of call centers and other telemedicine treatments to improve treatment outcomes and adherence in a rural population with advanced COPD. By incorporating dietary therapies with telemedicine, the management of COPD may be improved, lung function may be improved, and readmissions may be decreased. These results imply that adding telemedicine and nutritional treatments into conventional care may help enhance patient outcomes and COPD management.

Main Themes and Relationships among Sources

The connection between these sources emphasizes how crucial telehealth interventions are in modernizing healthcare delivery, enhancing patient outcomes, and addressing the difficulties in treating chronic illnesses like COPD. The research shows telemedicine has a favorable effect, emphasizing its potential to improve postoperative and follow-up care, encourage patient self-management and medication adherence, and eventually lead to improved clinical results. Further study and use of these strategies promise to transform healthcare and enhance patient lives as telehealth continues to advance (Iyer et al., 2022).

In order to better represent the many facets of COPD treatment and the function of telehealth interventions, the themes that emerge from the sources may be divided into several categories. Studies examining the effects of nutritional therapies on managing COPD and general well-being make up one significant subject, “Nutritional Intervention and COPD,” which is prevalent throughout the collection. These studies emphasize the potential advantages of whey drinks that have been supplemented, as well as the importance of nutrition in enhancing muscle growth, inflammation, functioning, and quality of life in COPD patients (Leonard et al., 2021).

“Telehealth and COPD Management,” another subject, examines the use of telehealth treatments in treating COPD. These studies look at how well telehealth initiatives affect patient outcomes, including lung function, quality of life, self-efficacy, and levels of depression. They stress the beneficial effects of telehealth treatments directed by medical experts, particularly nurses, on controlling COPD and patients’ well-being (Marcos et al., 2022). The “Hospital Readmissions and COPD Care” subject emphasizes how telehealth treatments might help COPD patients avoid hospital readmissions. These studies assess how post-discharge telemonitoring affects readmission and death rates, emphasizing the potential of telehealth services to reduce readmissions and enhance long-term outcomes in COPD patients (Mohr et al., 2023). The topics “Telehealth and Remote Care in COPD Management” and “Telehealth and Remote Monitoring in COPD Management” emphasize the use of telehealth treatments to provide remote care and monitoring for COPD patients. These studies examine the advantages of telemedicine-based follow-up management, telemedicine treatments, and video telehealth pulmonary rehabilitation in enhancing COPD self-management, medication adherence, and early identification of problems (Rassouli et al., 2021).

Potential Gaps

Despite the valuable information the evaluated studies provide, there still needs to be more knowledge about COPD and telemedicine therapies. First, additional randomized controlled studies (RCTs) are required to more conclusively verify a link between telemedicine treatments and better outcomes for COPD patients. The study contained many observational or non-randomized trials, making it difficult to reach firm conclusions regarding the efficacy of telehealth. Additionally, it is not easy to compare and generalize the results across studies because of the variety in the design and elements of telehealth treatments (Tian et al., 2021). To optimize the advantages of telehealth in the therapy of COPD, further study is needed to pinpoint the most efficient telehealth techniques, such as ideal delivery modalities, particular components, and targeted patient demographics. Additionally, while some studies looked at how telehealth interventions affected readmission and mortality rates, more research is required to examine other crucial outcomes, such as exacerbation rates, healthcare utilization, and cost-effectiveness, to fully assess the efficacy and viability of telehealth interventions in COPD care (Stellefson et al., 2022).

Conclusion NURS FPX 9902 Assessment 3 Literature Synthesis

The evaluated studies demonstrate the potential of telemedicine treatments in increasing the management of chronic obstructive pulmonary disease (COPD) and improving outcomes. The results point to the potential benefits of telehealth treatments, such as telemonitoring, telemedicine, and telerehabilitation, on several COPD care-related issues, including readmission reduction, lung function improvement, self-management improvement, and patient well-being promotion. Even though telemedicine was the primary focus of the trials, there is growing evidence that using nutritional therapies in conjunction with telehealth techniques may improve the management of COPD. The variety of telehealth therapies, the need for further randomized controlled trials, and the investigation of other outcomes than readmissions and death rates are all critical research gaps that must be acknowledged. Future studies should work to close these gaps and provide more information on the best methods for incorporating nutritional and telehealth treatments into COPD treatment, thereby enhancing the lives of people with this chronic respiratory ailment.

References

Ahmadi, A., Eftekhari, M. H., Mazloom, Z., Masoompour, M., Fararooei, M., Eskandari, M. H., Mehrabi, S., Bedeltavana, A., Famouri, M., Zare, M., Nasimi, N., & Sohrabi, Z. (2020). Fortified whey beverage for improving muscle mass in chronic obstructive pulmonary disease: A single-blind, randomized clinical trial. Respiratory Research21(1). https://doi.org/10.1186/s12931-020-01466-1 

Aldhahir, A. M., Rajeh, A. M. A., Aldabayan, Y. S., Drammeh, S., Subbu, V., Alqahtani, J. S., Hurst, J. R., & Mandal, S. (2020). Nutritional supplementation during pulmonary rehabilitation in COPD: A systematic review. Chronic Respiratory Disease17, 147997312090495. https://doi.org/10.1177/1479973120904953 

Alghamdi, S. M., Janaudis-Ferreira, T., Alhasani, R., & Ahmed, S. (2019). Acceptance, adherence and dropout rates of individuals with COPD approached in telehealth interventions: A protocol for systematic review and meta-analysis. BMJ Open9(4), e026794. https://doi.org/10.1136/bmjopen-2018-026794 

Alghamdi, S. M., & Rajeh, A. A. (2019). Top ten behavioral change techniques used in telehealth intervention with COPD: A systematic review. Respiratory Care64(Suppl 10)https://rc.rcjournal.com/content/64/Suppl_10/3229948.short 

Bhatt, S. P., Baugh, D., Hitchcock, J., Kim, Y., Cutter, G., Aban, I., & Dransfield, M. T. (2022). Video telehealth pulmonary rehabilitation for chronic obstructive pulmonary disease is associated with clinical improvement similar to center-based pulmonary rehabilitation. Annals of the American Thoracic Society19(2), 331–333. https://doi.org/10.1513/annalsats.202104-419rl 

Bhatt, S. P., Patel, S. B., Anderson, E. M., Baugh, D., Givens, T., Schumann, C., Sanders, J. G., Windham, S. T., Cutter, G. R., & Dransfield, M. T. (2019). Video telehealth pulmonary rehabilitation intervention in chronic obstructive pulmonary disease reduces 30-day readmissions. American Journal of Respiratory and Critical Care Medicine200(4), 511–513. https://doi.org/10.1164/rccm.201902-0314le 

Chahdi, M., Bruchhäuser, A., von Gahlen-Hoops, W., & Nydahl, P. (2023). Interventions to reduce hospital readmission rates in patient: Indoor with COPD: A systematic literature review. Medical clinic – Intensive care and emergency medicine. https://doi.org/10.1007/s00063-023-01003-0 

Cristina Rezende1, L., Geraldo Ribeiro1, E., Carvalho Parreiras1, L., Assunção Guimarães1, R., Maciel dos Reis1, G., Fernandes Carajá1, A., Batista Franco2, T., Patrícia de Souza Mendes1, L., Maria Augusto1, V., & Lara Silva1, K. (2023). Telehealth and telemedicine in managing adult patients after hospitalization for COPD exacerbation: A scoping review. Jornal Brasileiro de Pneumologia, e20220067. https://doi.org/10.36416/1806-3756/e20220067 

Deutz, N. E., Ziegler, T. R., Matheson, E. M., Matarese, L. E., Tappenden, K. A., Baggs, G. E., Nelson, J. L., Luo, M., Hegazi, R., & Jonnalagadda, S. S. (2020). Reduced mortality risk in malnourished hospitalized older adult patients with COPD treated with a specialized oral nutritional supplement: Sub-group analysis of the NOURISH study. Clinical Nutritionhttps://doi.org/10.1016/j.clnu.2020.08.031 

Eze, N. D., Mateus, C., & Cravo Oliveira Hashiguchi, T. (2020). Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation. PLOS ONE15(8), e0237585. https://doi.org/10.1371/journal.pone.0237585 

Frankfort, C. A., Greeninger, K., McFadden, R., Brinkman, D., Roldan, L., Addis, C., Klinger, R., Kenyon, C., & Pavlichko, M. S. (2021). An approach to post-discharge care to reduce COPD readmissions. Respiratory Care66(Suppl 10). https://rc.rcjournal.com/content/66/Suppl_10/3605213.short 

Furulund, E., Bemanian, M., Berggren, N., Madebo, T., Rivedal, S. H., Lid, T. G., & Fadnes, L. T. (2021). Effects of nutritional interventions in individuals with chronic obstructive lung disease: A systematic review of randomized controlled trials. International Journal of Chronic Obstructive Pulmonary Disease16, 3145–3156. https://doi.org/10.2147/COPD.S323736 

Hamadi, H. Y., Martinez, D., Xu, J., Silvera, G. A., Mallea, J. M., Hamadi, W., Li, X., Li, Y., & Zhao, M. (2020). Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality. Journal of Telemedicine and Telecare, 1357633X2097040. https://doi.org/10.1177/1357633×20970402 

Holst, M., Beck, A. M., Rasmussen, H. H., & Lange, P. (2019). Insufficient intake of energy and protein is related to physical functional capacity among COPD patients referred to municipality based pulmonary rehabilitation. Clinical Nutrition ESPEN30, 35–41. https://doi.org/10.1016/j.clnesp.2019.02.009 

Ingadottir, A. R., Beck, A. M., Baldwin, C., Weekes, C. E., Geirsdottir, O. G., Ramel, A., Gislason, T., & Gunnarsdottir, I. (2019). Oral nutrition supplements and between-meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: A randomised feasibility trial. BMJ Open Respiratory Research6(1). https://doi.org/10.1136/bmjresp-2018-000349 

Inoue, S., & Ikeda, H. (2019). Differences in plasma amino acid levels in patients with and without bacterial infection during the early stage of acute exacerbation of COPD. International Journal of Chronic Obstructive Pulmonary DiseaseVolume 14, 575–583. https://doi.org/10.2147/copd.s188422 

Iyer, A. S., Wells, R. D., Dionne-Odom, J. N., Bechthold, A. C., Armstrong, M., Byun, J. Y., O’Hare, L., Taylor, R., Ford, S., Coffee-Dunning, J., Dransfield, M. T., Brown, C. J., & Bakitas, M. A. (2022). Project EPIC (Early Palliative Care In COPD): A formative and summative evaluation of the EPIC telehealth intervention. Journal of Pain and Symptom Managementhttps://doi.org/10.1016/j.jpainsymman.2022.11.024 

Keogh, E., & Mark Williams, E. (2020). Managing malnutrition in COPD: A review. Respiratory Medicine176, 106248. https://doi.org/10.1016/j.rmed.2020.106248

Leonard, R., Forte, M., Mehta, D., Mujahid, H., & Stansbury, R. (2021). The impact of a telemedicine intervention on home non‐invasive ventilation in a rural population with advanced COPD. The Clinical Respiratory Journal15(7), 728–734. https://doi.org/10.1111/crj.13354 

Liu, F., Jiang, Y., Xu, G., & Ding, Z. (2020). Effectiveness of telemedicine intervention for chronic obstructive pulmonary disease in China: A systematic review and meta-analysis. Telemedicine and E-Healthhttps://doi.org/10.1089/tmj.2019.0215 

Marcos, P. J., Represas Represas, C., Ramos, C., Cimadevila Álvarez, B., Fernández Villar, A., Fraga Liste, A., Fernández Nocelo, S., Quiles Del Río, J., Zamarrón Sanz, C., Golpe, R., Abal Arca, J., Calvo Álvarez, U., Pértega, S., & García Comesaña, J. (2022). Impact of a home telehealth program after a hospitalized copd exacerbation: A propensity score analysis. Archivos de Bronconeumologia58(6), 474–481. https://doi.org/10.1016/j.arbres.2020.05.030 

Michaelchuk, W., Oliveira, A., Marzolini, S., Nonoyama, M., Maybank, A., Goldstein, R., & Brooks, D. (2022). Design and delivery of home-based telehealth pulmonary rehabilitation programs in COPD: A systematic review and meta-analysis. International Journal of Medical Informatics162, 104754. https://doi.org/10.1016/j.ijmedinf.2022.104754 

Mohr, N. M., Vakkalanka, J. P., Holcombe, A., Carter, K. D., McCoy, K. D., Clark, H. M., Gutierrez, J., Merchant, K. A. S., Bailey, G. J., & Ward, M. M. (2023). Effect of chronic disease home telehealth monitoring in the veterans health administration on healthcare utilization and mortality. Journal of General Internal Medicinehttps://doi.org/10.1007/s11606-023-08220-5 

Nguyen, H. T., Collins, P. F., Pavey, T. G., Nguyen, N. V., Pham, T. D., & Gallegos, D. L. (2019). Nutritional status, dietary intake, and health-related quality of life in outpatients with COPD. International Journal of Chronic Obstructive Pulmonary DiseaseVolume 14, 215–226. https://doi.org/10.2147/copd.s181322 

Rassouli, F., Germann, A., Baty, F., Kohler, M., Stolz, D., Thurnheer, R., Brack, T., Kähler, C., Widmer, S., Tschirren, U., Sievi, N. A., Tamm, M., & Brutsche, M. H. (2021). Telehealth mitigates COPD disease progression compared to standard of care: A randomized controlled crossover trial. Journal of Internal Medicine289(3), 404–410. https://doi.org/10.1111/joim.13230 

Snoswell, C. L., Stringer, H., Taylor, M. L., Caffery, L. J., & Smith, A. C. (2021). An overview of the effect of telehealth on mortality: A systematic review of meta-analyses. Journal of Telemedicine and Telecare, 1357633X2110237. https://doi.org/10.1177/1357633×211023700 

Stellefson, M., Kinder, C., Boyd, I., Elijah, O., Naher, S., & McFadden, N. (2022). COPD self-management for adults living in rural areas: Systematic review of telehealth and non-telehealth interventions. American Journal of Health Education53(5), 269–281. https://doi.org/10.1080/19325037.2022.2100525 

Tian, M., Wang, B., Xue, Z., Dong, D., Liu, X., Wu, R., Yu, L., Xiang, J., Zhang, X., Zhang, X., & Lv, Y. (2021). Telemedicine for follow-up management of patients after liver transplantation: Cohort study. JMIR Medical Informatics9(5), e27175. https://doi.org/10.2196/27175 

van Beers, M., Rutten-van Mölken, M. P. M. H., van de Bool, C., Boland, M., Kremers, S. P. J., Franssen, F. M. E., van Helvoort, A., Gosker, H. R., Wouters, E. F., & Schols, A. M. W. J. (2020). Clinical outcome and cost-effectiveness of a 1-year nutritional intervention programme in COPD patients with low muscle mass: The randomized controlled NUTRAIN trial. Clinical Nutrition39(2), 405–413. https://doi.org/10.1016/j.clnu.2019.03.001 

Wong, A. K. C., Bayuo, J., Wong, F. K. Y., Yuen, W. S., Lee, A. Y. L., Chang, P. K., & Lai, J. T. C. (2022). Effects of a nurse-led telehealth self-care promotion program on the quality of life of community-dwelling older adults: Systematic review and meta-analysis. Journal of Medical Internet Research24(3), e31912. https://doi.org/10.2196/31912 

Leave a Comment

Your email address will not be published. Required fields are marked *

Please Fill The Following to Resume Reading

    Please Enter Active Contact Information For OTP

    Verification is necessary to avoid bots.
    Please Fill The Following to Resume Reading

      Please Enter Active Contact Information For OTP

      Verification is necessary to avoid bots.
      Scroll to Top
      × How can I help you?