{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:44:13Z","timestamp":1778125453059,"version":"3.51.4"},"reference-count":54,"publisher":"BMJ","issue":"5","funder":[{"name":"The Danish Agency for Digitalization, Policy and Strategy"},{"name":"The North Denmark Region"},{"DOI":"10.13039\/501100004895","name":"The European Social Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004895","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The 11 municipalities in the North Denmark Region"},{"name":"The Obel Family Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,3,2]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the effect of telehealthcare compared with usual practice in patients with chronic obstructive pulmonary disease (COPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cluster-randomised trial with 26 municipal districts that were randomly assigned either to an intervention group whose members received telehealthcare in addition to usual practice or to a control group whose members received usual practice only (13 districts in each arm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twenty-six municipal districts in the North Denmark Region of Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients who fulfilled the Global Initiative for COPD guidelines and one of the following criteria: COPD Assessment Test score \u226510; or Medical Research Dyspnoea Council Scale \u22653;\u2009or Modified Medical Research Dyspnoea Council Scale \u22652; or \u22652 exacerbations during the past 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Health-related quality of life (HRQoL) assessed by the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form 36-Item Health Survey, Version 2. Data were collected at baseline and at 12\u2009month follow-up and analysed according to the intention-to-treat principle with complete cases, n=574 (258 interventions; 316 controls) and imputed data, n=1225 (578 interventions, 647 controls) using multilevel modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the intention-to-treat analysis (n=1225), the raw mean difference in PCS from baseline to 12\u2009month follow-up was \u22122.6 (SD 12.4) in the telehealthcare group and \u22122.8 (SD 11.9) in the usual practice group. The raw mean difference in MCS scores in the same period was \u22124.7 (SD 16.5) and \u22125.3 (SD 15.5) for telehealthcare and usual practice, respectively. The adjusted mean difference in PCS and MCS between groups at 12 months was 0.1 (95% CI \u22121.4 to 1.7) and 0.4 (95% CI \u22121.7 to 2.4), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The overall sample and all subgroups demonstrated no statistically significant differences in HRQoL between telehealthcare and usual practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT01984840; Results.<\/jats:p>\n                  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