DAN-COPD
DAN-COPD
The research group behind the research program consists of representatives from Aalborg University and DEFACTUM, Central Denmark Region and Aarhus University. The research program is divided according to the two research methods, where the quantitative part is covered by a sub-project carried out by Aalborg University, and the qualitative part is covered by a sub-project carried out by DEFACTUM, Central Denmark Region and Aarhus University.
What? The aim of the research programme, DAN-COPD, is to make a multidisciplinary evaluation of the national implementation of telehealthcare in Denmark for patients with Chronic Obstructive Pulmonary Disease (COPD). The research program addresses both the political, administrative, health professional and patient perspectives, and will contain both quantitative and qualitative methods.
Why? The interest in telehealthcare technologies, tools and services in the healthcare sector has increased significantly during the COVID-19 pandemic, and telehealthcare is becoming an important part of our healthcare system. The interest in implementing telehealthcare on a large scale was already increasing before the pandemic, but the pandemic has revealed telehealthcare as a key component of a future patient-centred, safe and efficient healthcare system. It is therefore urgent to improve the evidence for the application of telehealthcare interventions. Denmark is a pioneer in the digitization of the healthcare system, including telehealthcare, and will be the first country to implement telehealthcare as a national treatment option for patients with a number of chronic diseases, with COPD being first in line. Therefore, a systematic evaluation of the national implementation of telehealthcare for patients with COPD in Denmark can provide essential information that can guide the effective implementation of future telehealthcare solutions for both COPD and other conditions in Denmark and internationally.
How? The research program is divided into four complementary work packages that represent the different perspectives, research disciplines and methods (quantitative and qualitative). An overview of the structure and content of the research program is visualized in the figure below.
The quantitative sub-project in DAN-COPD
The quantitative sub-project of the research programme, DAN-COPD, consists of four sub-studies, all of which contribute to the evaluation of the national implementation of telehealthcare for patients with COPD in Denmark. The four sub-studies are described below:
Substudy 1: Uptake of telehealthcare among patients with Chronic Obstructive Pulmonary Disease
The purpose of sub-study 1 is to investigate the uptake of telehealthcare among patients with COPD, including identifying patient- and system-related predictors for the use of telehealthcare.
The substudy is designed as a registry-based, observational cohort study among patients with COPD who have been assessed as suitable for telehealthcare. The sub-study is expected to be able to contribute with knowledge about the population receiving telehealthcare, knowledge about potential differences between patients who receive telehealthcare and those who do not, and knowledge about potential regional, socio-economic and demographic predictors of whether patients are offered telehealthcare and accept it. The results will also form the basis for adjustment for potential differences in the other sub-studies.
Substudy 2: The effect of telehealthcare on treatment quality, clinical effects and costs among patients with Chronic Obstructive Pulmonary Disease
The purpose of substudy 2 is to investigate the effect of telehealthcare for patients with COPD on the quality of treatment, clinical effects and costs, including fulfilment of process indicators, the occurrence of hospitalizations, outpatient visits, emergency visits, visits to the general practitioner, medication consumption, and mortality.
The substudy will be designed as a prospective, observational cohort study that examines the fulfilment of process indicators, the frequency of services in the healthcare system and the accumulation of costs among patients with COPD receiving telehealthcare compared to a matched patient cohort receiving standard care. The substudy will be based on register data from the national health registers. The substudy is expected to contribute with knowledge about the effect telehealthcare has on the frequency of services in the healthcare system, the accumulation of costs, and the quality of treatment. The results are also expected to contribute to substudy 4.
Substudy 3: Does telehealthcare improve the quality of life of patients with Chronic Obstructive Pulmonary Disease?
The purpose of substudy 3 is to estimate and compare patient-perceived effects for patients with COPD who receive telehealthcare compared to patients with COPD who receive the standard treatment.
The substudy will be designed as a national prospective cohort study among patients using telehealthcare and patients receiving the standard treatment. The substudy will include an estimation and comparison of patient-perceived effect at a baseline (at the start of telehealthcare) and after 12 months of telehealthcare. The patient-perceived effect will be measured with selected validated questionnaires consisting of:
- European Quality of Life – 5 Dimensions – 5 levels (EQ-5D-5L), which is a validated questionnaire that examines the health-related quality of life
- IICEpop CAPability measure (ICECAP-A), which is a validated questionnaire that examines the quality of life in terms of well-being
- Patient Health Engagement Scale (PHE-S), which is a validated questionnaire that examines patient engagement in their treatment, also called self-management (empowerment)
- The COPD Assessment Test (CAT), which is a validated questionnaire that examines the impact of the COPD diagnosis on the patients' health.
The results are expected to be able to contribute with knowledge about the effect of telehealthcare in relation to the effect experienced by the patient, as well as whether there is a difference in which aspects of the patient's quality of life are affected by telehealthcare. The results are also expected to be able to contribute to substudy 4.
Substudy 4: Economic evaluation of telehealthcare compared to the standard treatment for patients with Chronic Obstructive Pulmonary Disease in Denmark.
The purpose of substudy 4 is to investigate the health economic consequences of telehealthcare compared to the standard treatment for patients with COPD in Denmark by using real-life evidence on the cost accumulation and the patient-perceived effect. The substudy will include relevant knowledge from the previous substudies and will contribute knowledge about the cost-effectiveness of telehealthcare for patients with COPD in a real-life perspective in Denmark.
Financing: The research programme is financed by Sygesikringen ”Danmark”. Furthermore, the quantitative sub-project is supported by Trygfonden and Region Nordjyllands Sundhedsvidenskabelige Forskningsfond ”Yngre forsker stipendium”.
If there are any questions, you are welcome to contact the research group behind the quantitative sub-project of the research programme, DAN-COPD.
The research group at Aalborg University
For more information on the qualitative part, refer to DEFACTUM, Central Denmark Region and Aarhus University. It is possible to read more about the sub-project on their website.