Evidence regarding telemedicine-based disease management in COPD is conflicting and limited by the small patient numbers, use of variable intensities of telemonitoring, and lack of prespecified treatment plans [238]. In a randomised trial of patients with chronic respiratory failure (42% had COPD), those randomised to receive tele-assistance had fewer hospitalisations, less urgent calls, and decreased acute exacerbations. In the COPD subgroup, there were decreased home visits and hospitalisations among those who were managed via the tele/home care model, with a substantial cost saving at 6 months [239]. In contrast, another study found that home-based COPD telemonitoring programmes conferred no benefit in
decreasing hospital or homecare costs [240, 241].