Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with a high health care resource consumption and health care expenditures, driven mainly by exacerbations-related hospitalizations. Telemedicine has been proposed as a mean for timely detection of exacerbation, but the available evidence is inadequate to provide conclusive information on its efficacy. The aim of this study is to evaluate the efficacy of a telemonitoring system in reducing COPD-related hospitalizations in an elderly population with COPD.MethodsThis is a parallel arms, randomized trial including patients aged 65 or older with COPD in GOLD stages II and III enrolled in a Pulmonary Medicine outpatient facility. Patients were randomly assigned to receive a non-invasive system able to telemonitor vital signs (oxygen saturation, heart rate, near-body temperature, overall physical activity) or standard care, and were followed up for 9 months. The outcome measures were the number of exacerbations and exacerbation-related hospitalization.ResultsFifty patients were included in the telemonitoring group and 49 in the control group. The incidence rate of respiratory events was 28/100 person/years in the telemonitoring group vs. 42/100 person/years in the control group (incidence rate ratio: 0.67, 95% CI: 0.32 – 1.36). The corresponding figures for hospital admissions where 13/100 person/years and 20/100 person/years, respectively (IRR: 0.66, 95% CI: 0.21 – 1.86).ConclusionsIn our study, COPD patients followed up with the aid of a multiparametric remote monitoring system experienced a lower rate of exacerbations and COPD-related hospitalizations compared to patients followed up using the standard model of care. These results need to be replicated in larger studies before they can be applied to the general COPD population. Trial registration number: NCT01481506 (clinicaltrials.gov). Funding: co-financed by Lazio Region and Intersistemi Inc.
Highlights
Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with a high health care resource consumption and health care expenditures, driven mainly by exacerbations-related hospitalizations
Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition that is expected to be the third cause of death worldwide by 2020 [1]
Eligibility criteria were age ≥ 65 years and diagnosis of COPD stage II or III according to the Global initiative for Obstructive Lung Disease (GOLD) criteria: forced expiratory volume in the first second (FEV1) / forced vital capacity (FVC) < 0.7 and 30%
Summary
Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with a high health care resource consumption and health care expenditures, driven mainly by exacerbations-related hospitalizations. Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition that is expected to be the third cause of death worldwide by 2020 [1] It is associated with important risk of disability with a related very high use of health care resources. Comorbidity, Telemonitoring of COPD patients has been so far based upon programmed or on demand vocal interaction or periodical transmission of expiratory peak flow or transcutaneous oxygen saturation (SaO2) [8,9,10,11] All these interventions are monodimensional in nature and episodic or periodic in their timing, and have yielded mixed results with respect to cost reduction and quality of life improvement. COPD, mainly in the presence of cardiovascular comorbidity, is multidimensional in its impact on health status [12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
