Zusammenfassung
Telemedizinischen Anwendungen wird häufig das Ziel attestiert, die Lebensqualität
von Patienten zu erhöhen. Der vorliegende Beitrag fasst den Forschungsstand zum Einfluss
telemedizinischer Anwendungen auf die Lebensqualität zusammen. Derzeit existieren
nur wenige Studien, die standardisierte Instrumente zur Erfassung der Lebensqualität
in kontrollierten Designs eingesetzt haben, vornehmlich in Studien mit Patienten mit
Herzinsuffizienz, Diabetes und psychischen Störungen. Die Evidenz im Hinblick auf
die Erhöhung der Lebensqualität von Patienten ist derzeit uneindeutig. Methodisch
sind spezifische Module, z. B. zur Outcome-Erfassung von Patienten und zur Erfassung
des Sicherheitserlebens in Lebensqualitätsinstrumenten in Ergänzung zu integrieren.
Zukünftig erscheint es sinnvoll, Telefonzuwendung bzw. -beratung und das Monitoring
von Vitalparametern in ihren unabhängigen Effekten auf die Lebensqualität zu überprüfen.
Summary
It is often assumed that the use of telemedicine enhances patients’ quality of life.
The current overview summarises the state of the art concerning telemedicine and quality
of life. There are only a few studies that have used standardized instruments to assess
quality of life in controlled studies, particularly in patients with chronic heart
failure, diabetes ans psychological disabilities. To date, there is no clear evidence
concerning the impact of telemedicine on patients’ quality of life. Assessment instruments
need to be more specific and should integrate perceived security as an outcome dimension.
Future studies should focus on analysing the specific influence of individual parameters
of distant monitoring on patients’ quality of life.
Schlüsselwörter
Telemedizin - Telemonitoring - Lebensqualität - Patient-reported outcomes
Key words
Telemedicine - Telemonitoring - Quality of life - Patient-reported outcomes
Literatur
- 1
Ades P A, Pashkow F J, Fletcher G, Pina I L, Zohman L R, Nestor J R.
A controlled trial of cardiac rehabilitation in the home setting using electrocardiographic
and voice transtelephonic monitoring.
Amer Heart J.
2000;
139
543-548
- 2
Benatar D, Bondmass M, Ghitelman J, Avitall B.
Outcomes of chronic heart failure.
Arch Intern Med.
2003;
163
347-352
- 3
Chambers A, Hennesy E, Powell-Tuck J.
Longitudinal trends in quality of life after starting home parenteral nutrition: a
randomised controlled study of telemedicine.
Clin Nutr.
2006;
25
505-514
- 4
Cherry J C, Dryden K, Kobb R, Hilsen P, Nedd N.
Opening a window of opportunity through technology and coordination: a multisite case
study.
Telemedicine and e-Health.
2003;
9
265-271
- 5
Cherry J C, Moffatt T P, Rodriguez C, Dryden K.
Diabetes disease management program for an indigent population empowered by telemedicine
technology.
Diabetes Technology & Therapeutics.
2002;
4
783-791
- 6
Chumbler N R, Neugaard B, Kobb R, Ryan P, Qin H, Joo Y.
Evaluation of a care coordination/home-telehealth program for veterans with diabetes.
Evaluation & the Health Professions.
2005;
28
464-478
- 7
Cleland J G, Louis A, Rigby A, Janssens U, Balk A.
Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent
admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS)
study.
J Am Coll Cardiol.
2005;
45
1654-1665
- 8
De Lusignan S.
Compliance and effectiveness of 1 year’s home telemonitoring. The report of a pilot
study of patients with chronic heart failure.
Europ J Heart Failure.
2001;
3
723-730
- 9
Dunagan W C, Littenberg B, Ewald G A, Jones C A, Emery V B, Watermann B M, Silverman D C,
Rogers J G.
Randimized trial of a nurse-administred, telephone-based disease management program
for patients with heart failure.
J Cardiac Failure.
2005;
11
358-365
- 10
Egner A, Phillips V L, Vora R, Wiggers E.
Depression, fatigue, and health-related quality of life among people with advanced
multiple sclerosis: results from an exploratory telerehabilitation study.
NeuroRehabilitation.
2003;
18
125-133
- 11
Goulis D G, Giaglis G D, Boren S A, Lekka I, Bontis E, Balas E A, Maglaveras N, Avramides A.
Effectiveness of home-centred care through telemedicine applications for overweight
and obese patients: a randomized controlled trial.
Int J Relat Metab Disord.
2004;
28
1391-1398
- 12 Hersh W. Evidence Report Telemedicine. US Health Serv Agency 2006
- 13
Izquiero R E, Knudson P E, Meyer S, Kearns J, Ploutz-Snyder R, Weinstock R S.
A comparison of diabetes education administred through telemedicine versus in person.
Diabetes Care.
2003;
26
1002-1007
- 14
Kortke H, Zittermann A, El-Arousy M, Zimmermann E, Wienecke E, Korfer R.
Neues Ostwestfälisches Postoperatives Therapiekonzept (NOPT). Eine telemedizinisch
betreute Studie zur ambulanten Rehabilitation von Patienten nach kardiochirurgischen
Operationen.
Med Klin.
2005;
100
383-389
- 15
Montori V M, Helgemoe P K, Guyatt G H, Dean D S, Leung T W, Smith S A, Kudva Y C.
Telecare for patients with type 1 diabetes and inadequate glymic control: a randimized
trial and meta-analysis.
Diabetes care.
2004;
27
1088-1094
- 16
Rector T S, Kubo S H, Cohn J N.
Validity of the Minnesota Living with Heart Failure questionnaire as a measure of
therapeutic response to enalapril or placebo.
Am J Cardiol.
1993;
71
1106-1107
- 17
Rollman B L, Herbeck B, Mazumdar S, Houck P R, Zhu F, Gardner W, Reynolds C F, Schulberg H C,
Shear M.
A randomized trial to improve the quality of treatment for panic and generalized anxiey
disorders in primary care.
Arch Gen Psychiatry.
2005;
62
1332-1341
- 18
Roth A, Kajiloti I, Elkayam I, Sander J, Kehati M, Golovner M.
Telecardiology for patients with chronic heart failure: the „SHL” experience in Israel.
Int J Cardiol.
2004;
97
49-55
- 19
Scalvini S, Caopmolla S, Zanelli E, Benigno M, Domenighini D, Paletta L, Glisenti F,
Giordano A.
Effect of home-based telecardiology on chronic heart failure: costs and outcomes.
J Telemed Telecare.
2005;
11
(Suppl 1)
16-18
- 20 Schmidt S, Bartelt C, Schuchert A, Meinertz T. Effect of different diagnostic strategies
on patient-reported-outcomes with recurrent syncope of unknown origin. in prep 2006
- 21
Schmidt S, Koch U.
Akzeptanz der Gesundheitstelematik bei ihren Anwendern.
Bundesgesundheitsblatt.
2005;
7
778-789
- 22
Schmidt S, Koch U.
Telemedizin aus einer medizinpsychologischen Perspektive- Die Bedeutung von Telematikanwendungen
für die Arzt-Patientenbeziehung und -kommunikation.
Z Med Psychol.
2003;
3
67-71
- 23 Schmidt S, Stettin J. Lässt sich die Medikamenteneinnahme in der häuslichen Versorgung
mit Telemidezin unterstützen?. e-health_com 2006
- 24
Smart N, Haluska B, Jeffries L, Marwick T H.
Predictors of a sustained response to exercise training in patients with chronic heart
failures: a telemonitoring study.
Amer Heart J.
2005;
150
1240-1247
- 25
Urness D, Wass M, Gordon A, Tian E, Bulger T.
Client acceptability and quality of life - telepsychiatry compared to in-person consultation.
J Telemed Telecare.
2006;
12
251-254
- 26
Ware J E, Gandek B, Kosinski M A, Aaronson N K, Apolone G, Brazier J, Bullinger M,
Kaasa S, Leplege A, Prieto L, Sullivan M, Thunedborg K.
The equivalence of SF-36 summary health scores estimated using standard and country-specific
agorithms in 10 countries: Results from the IQOLA Project.
Social Science and Medicine.
1998;
51
1167-1170
- 27
WHOQOL-Group .
The World Health Organization Quality of Life Assessment (WHOQOL): Position paper
from the World Health Organization.
Social Science and Medicine.
1995;
41
1403-1409
- 28
Williams T L, May C R, Esmail A, Griffiths C E, Shaw N T, Fitzgerald D, Stewart E,
Mould M, Morgan M, Pickup L, Kelly S.
Patient satisfaction with teledermatology is related to perceived quality of life.
Br J Dermatology.
2001;
145
911-917
Priv.-Doz. Dr. Silke Schmidt
Arbeitsgruppe Telemedizin und Versorgungsforschung, Institut und Poliklinik für Medizinische
Psychologie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg Eppendorf
Martinistr. 52, Haus S35
22046 Hamburg
Phone: 040/428036206
Fax: 040/428034940
Email: sischmid@uke.uni-hamburg.de