Introduction: Telehealth (TH) interventions with Chronic Obstructive Pulmonary Disease (COPD) management were introduced in the literature more than 20 years ago with different labeling, but there was no summary for the overall acceptance and dropout rates as well as associated variables. Objective: This review aims to summarize the acceptance and dropout rates used in TH interventions and identify to what extent clinical settings, sociodemographic factors, and intervention factors might impact the overall acceptance and completion rates of TH interventions. Methods: We conducted a systematic search up to April 2021 on CINAHL, PubMed, MEDLINE (Ovid), Cochrane, Web of Sciences, and Embase to retrieve randomized and non-randomized control trials that provide TH interventions alone or accompanied with other interventions to individuals with COPD. Results: Twenty-seven studies met the inclusion criteria. Overall, the unweighted average of acceptance and dropout rates for all included studies were 80% and 19%, respectively. A meta-analysis on the pooled difference between the acceptance rates and dropout rates (weighted by the sample size) revealed a significant difference in acceptance and dropout rates among all TH interventions 51% (95% CI 49% to 52; p < 0.001) and 63% (95% CI 60% to 67; p < 0.001), respectively. Analysis revealed that acceptance and dropout rates can be impacted by trial-related, sociodemographic, and intervention-related variables. The most common reasons for dropouts were technical difficulties (33%), followed by complicated system (31%). Conclusions: Current TH COPD interventions have a pooled acceptance rate of 51%, but this is accompanied by a high dropout rate of 63%. Acceptance and dropout levels in TH clinical trials can be affected by sociodemographic and intervention-related factors. This knowledge enlightens designs for well-accepted future TH clinical trials. PROSPERO registration number CRD4201707854.

中文翻译：

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慢性阻塞性肺疾病患者对电子健康临床试验的接受程度

简介：20多年前文献中就介绍了慢性阻塞性肺疾病（COPD）管理的远程医疗（TH）干预措施，并有不同的标签，但没有对总体接受率和退出率以及相关变量进行总结。目的：本综述旨在总结 TH 干预措施的接受率和退出率，并确定临床环境、社会人口因素和干预因素可能在多大程度上影响 TH 干预措施的总体接受率和完成率。方法：我们在 CINAHL、PubMed、MEDLINE (Ovid)、Cochrane、Web of Sciences 和 Embase 上进行了截至 2021 年 4 月的系统检索，以检索单独提供 TH 干预措施或与其他干预措施相结合的随机和非随机对照试验患有慢性阻塞性肺病。结果：27 项研究符合纳入标准。总体而言，所有纳入研究的未加权平均接受率和退出率分别为 80% 和 19%。对接受率和退出率（按样本量加权）之间的汇总差异进行的荟萃分析显示，所有 TH 干预措施的接受率和退出率之间存在显着差异 51%（95% CI 49% 至 52；p < 0.001）和 63%（95% CI 60% 至 67；p < 0.001）。分析显示，接受率和辍学率可能受到试验相关、社会人口统计学和干预相关变量的影响。退出的最常见原因是技术困难（33%），其次是系统复杂（31%）。结论：当前 TH COPD 干预措施的总体接受率为 51%，但伴随着 63% 的高退出率。TH 临床试验的接受度和退出水平可能受到社会人口统计学和干预相关因素的影响。这些知识为未来广受接受的 TH 临床试验的设计提供了启发。PROSPERO 注册号 CRD4201707854。