Abstract
Chronic obstructive pulmonary disease (COPD) is the leading cause of death worldwide, and poses a substantial economic and social burden. Telemonitoring has been proposed as a solution to this growing problem, but its impact on patient outcome is equivocal. This randomized controlled trial aimed to investigate effectiveness of telemonitoring in improving COPD patient outcome. In total, 106 subjects were randomly assigned to the telemonitoring (n = 53) or usual care (n = 53) group. During the two months following discharge, telemonitoring group patients had to report their symptoms daily using an electronic diary. The primary outcome measure was time to first re-admission for COPD exacerbation within six months of discharge. During the follow-up period, time to first re-admission for COPD exacerbation was significantly increased in the telemonitoring group than in the usual care group (p = 0.026). Telemonitoring was also associated with a reduced number of all-cause re-admissions (0.23 vs. 0.68/patient; p = 0.002) and emergency room visits (0.36 vs. 0.91/patient; p = 0.006). In conclusion, telemonitoring intervention was associated with improved outcomes among COPD patients admitted for exacerbation in a country characterized by a small territory and high accessibility to medical services. The findings are encouraging and add further support to implementation of telemonitoring as part of COPD care.
Highlights
Score 1 if weight gain ≥ 1 kg in one day Score 2 if weight gain ≥ 2 kg in three days
About one-third of the patients were classified as having severe-to-very severe Chronic obstructive pulmonary disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification[1]
Among a set of patients discharged after hospitalization for COPD exacerbation, our results showed that telemonitoring intervention significantly postponed the time to first re-admission for exacerbation of COPD during a six-month follow-up
Summary
Score 1 if weight gain ≥ 1 kg in one day Score 2 if weight gain ≥ 2 kg in three days. Score 1 if daily increase in mMRC Dyspnea Scale of 1 grade Score 2 if daily increase in mMRC Dyspnea Scale of ≥ 2 grade. It should be investigated whether telemonitoring conveys similar advantages for patients with COPD in a small country.
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