Edinburgh Napier University

  Five year records based follow up of the participants in two telemonitoring trials will be carried out for the following reasons
1. Chronic Obstructive Pulmonary Disease (COPD) is an incurable, progressive lung condition characterised by intermittent acute exacerbations which require hospital admission, both distressing to the patient and costly. A RCT was carried out to see if daily telemonitoring could identify and treat exacerbations at an early stage and reduce hospital admissions. No differences were found between the telemonitoring and control groups. However, normal care had been improved and both groups had a longer time to hospital admission than expected based on previous clinical data. It is possible that differences between the groups emerged beyond the 1 year follow up. Clinically, it is really important to determine this happened as telemonitoring in COPD has largely been discontinued on the basis of this study.
2. A second reason for carrying out this linkage is methodological. There is increasing interest in records based trial follow up. During the 1 year follow up of patients in this study reason for hospital admission was based on detailed review of notes by 2 doctors. This linkage provides an ideal opportunity to compare these data from the trial record with the hospital admission data obtained from TRAK.
3. Hypertension is a modifiable risk factor for stroke and cardiovascular disease, but it is frequently not well controlled, with lack of trust in blood pressure measurements taken in the surgery being a problem. A RCT was carried out to see if telemonitoring could facilitate improved BP control. A significant difference between intervention and control groups was found, mainly due to the increases in prescribing of anti-hypertensive medication observed in the intervention group. The purpose of this study is to determine if the differences in prescribing between the two groups persist and to determine the rate of stroke and myocardial infarction within this group over 5 years.