Objective\nAs the global burden of chronic disease rises, policy makers are showing a strong interest\nin adopting telehealth technologies for use in long term condition management, including\nCOPD. However, there remain barriers to its implementation and sustained use. To date,\nthere has been limited qualitative investigation into how users (both patients/carers and\nstaff) perceive and experience the technology. We aimed to systematically review and\nsynthesise the findings from qualitative studies that investigated user perspectives and\nexperiences of telehealth in COPD management, in order to identify factors which may\nimpact on uptake.\nMethod\nSystematic review and meta-synthesis of published qualitative studies of user (patients,\ntheir carers and clinicians) experience of telehealth technologies for the management of\nChronic Obstructive Pulmonary Disease. ASSIA, CINAHL, Embase, Medline, PsychInfo\nand Web of Knowledge databases were searched up to October 2014. Reference lists of\nincluded studies and reference lists of key papers were also searched. Quality appraisal\nwas guided by an adapted version of the CASP qualitative appraisal tool.\nFindings\n705 references (after duplicates removed) were identified and 10 papers, relating to 7 studies\nwere included in the review. Most authors of included studies had identified both positive\nand negative experiences of telehealth use in the management of COPD. Through a line of\nargument synthesis we were able to derive new insights from the data to identify three overarching\nthemes that have the ability to either impede or promote positive user experience of telehealth in COPD: the influence on moral dilemmas of help seekingââ?¬â?(enables dependency\nor self-care); transforming interactions (increases risk or reassurance) and reconfiguration\nof ââ?¬Ë?workââ?¬â?¢ practices (causes burden or empowerment).\nConclusion\nFindings from this meta-synthesis have implications for the future design and implementation\nof telehealth services. Future research needs to include potential users at an earlier\nstage of telehealth/service development.
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