Keywords: Respiratory diseases; Remote population; self-managment; multimorbidity; primary healthcare

Background:

Patients with chronic respiratory diseases, such as asthma or COPD, living in remote areas face significant challenges in managing their conditions. Limited access to timely medical care, insufficient disease self-management hinder effective health outcomes. As part of the JARED (Joint Action for Respiratory Diseases; No EU4H-2023-JA-3-IBA) initiative, this pilot study investigates strategies to improve self-management for multimorbid patients using a telemedicine platform. The study emphasizes tailored self-management recommendations and nurse-led remote supervision to address the unique challenges faced by these populations.

Research questions:

Can nurse-led interventions improve self-management and patient engagement among multimorbid patients with asthma or COPD in remote areas compared to independent self-management using a telemedicine platform?

Method:

This randomized, intervention-controlled pilot study recruits multimorbid patients with asthma or COPD from regional primary healthcare centers. Participants are randomly assigned to an intervention group or a control group. During their first visit, all patients receive training on using the telemedicine platform and educational materials on disease management, identifying warning signs, and maintaining self-management routines. For a period of six months, both groups will complete monthly self-management questionnaires for asthma or COPD. The intervention group receives monthly nurse-led support in self-management, while the control group completes self-management independently. Quantitative analyses will assess patient engagement, adherence, and self-management improvement. Additionally, focus group interviews with patients and nurses will explore experiences with the program and identify opportunities for process refinement.

Results:

The study is currently in progress. Notable achievements so far include conducting nurse training sessions and recruiting multimorbid patients with asthma or COPD.

Conclusions:

This research will provide insights into the effectiveness of nurse-led interventions in improving self-management in primary healthcare for patients with chronic respiratory diseases in remote regions. Focus group interviews will offer insights into patient and nurse experiences, identifying challenges and opportunities to enhance telemedicine-based self-management for multimorbid patients.

Points for discussion:

Telemedicine as a Tool for Multimorbid Patients: the potential of telemedicine platforms in overcoming challenges faced by multimorbid asthma and COPD patients in remote areas, including limited access to specialized care and resources.

The Role of Nurse-Led Interventions in Remote Care: Exploring how nurse-led interventions, such as monthly support and personalized guidance, can enhance patient engagement, adherence, and self-management compared to independent self-monitoring.