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In the present study, we focus on the WSD telehealth questionnaire study and report on the effect of telehealth on health related Qo L and two psychological outcomes (anxiety and depressive symptoms).

Analyses were conducted for 759 participants who completed questionnaire measures at all three time points (complete case cohort) and 1201 who completed the baseline assessment plus at least one other assessment (available case cohort).

The WSD telehealth trial is a pragmatic, cluster randomised controlled trial of telehealth (n=3230).

This paper reports on the nested WSD telehealth questionnaire study, which was designed to include 1650 participants.

Generic health related Qo L, anxiety, and depression are outcomes relevant to patients with the three long term conditions that are the focus of the Whole Systems Demonstrator (WSD) Evaluation.18 It is well established that health related Qo L is reduced and anxiety and depression are elevated for patients with diabetes,19 20 21 chronic obstructive pulmonary disease,22 23 24 and heart failure.25 26 27 Health related Qo L, anxiety, and depression have been linked with poorer outcomes on endpoints including self management, disease control, health service use, costs, and mortality.28 29 30 31 32However, evidence for the effect of telehealth on these outcomes is unclear.

At least seven systematic reviews have examined this effect on health related Qo L in heart failure,33 34 35 36 37 38 39 and while most conclude that telehealth is beneficial, such inferences are not supported by the evidence they present.

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