The Virtual Hospital - a Clinical Trial

In addition to the main study, two sub studies will be conducted, using the same intervention and subjects as the main study; 1. COPD patients´ self-efficacy after virtual admission compared to hospital admission - implications for clinical practice 2. Cognitive function and daily life after virtual admission compared to conventional hospital admission in patients with chronic obstructive pulmonary disease (COPD) \-------------------------------------------------------------------------------- Ad. 1: COPD patients´ self-efficacy after virtual admission compared to hospital admission - implications for clinical practice Background: In order to transfer the patient from the hospital to the telemedicine based homecare treatment regimen, the patient must be able to perform tests and treatments and also contribute to identification of problems and changes in the physical condition. However, so far it has not been investigated whether patients using telehomecare have or acquire the necessary skills to cope with the problems entailed by COPD, in interaction with healthcare professionals and relatives. Aim: The primary aim of this sub study is to describe what characterizes COPD patients´ self-efficacy after virtual admission compared to hospital admission. Method: Self-efficacy will be measured using "The COPD self-efficacy scale", developed by Wigal et al (Chest 1991). The mean score will be compared between the two study arms, and furthermore the changes within the two groups will be assessed. Data will be collected at baseline, and also three days, six weeks and three months after discharge. In addition, analyses will be conducted to explore the association between self-efficacy, readmission and the use of bed days during a three month follow-up period. \-------------------------------------------------------------------------------- Ad.2: Cognitive function and daily life after virtual admission compared to conventional hospital admission in patients with chronic obstructive pulmonary disease (COPD) Background: COPD affects distant organs and causes several complications, including cognitive dysfunction. The impairment forms a significant clinical problem with consequences for the patients such as dependency on help for basic daily activities, increased symptom experience and poor compliance with medical treatment. Aim: The aim of the study is to investigate cognitive function and daily life after virtual admission compared to conventional hospital admission in patients with COPD. The study is a part of a randomized multicenter trial, investigating the feasibility and safety of a telemedicine based treatment regime in COPD patients, compared to conventional hospital treatment (Telemedicine technology makes it possible to communicate with the patient using a video conference system connected to a telemedicine communication platform). Method: For this sub study, we consecutively include 150 patients from the multicenter trial. The primary outcome will be cognitive function evaluated by a neuropsychological test battery (ISPOCD), including verbal learning, memory capacity and attention, at discharge, and six weeks after discharge. The secondary outcomes is daily life evaluated by questionnaires including self-reported cognitive function, self-efficacy, activities of daily living, health related quality of life, anxiety and depression, at discharge, six weeks and three months after discharge.