Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease: a randomized clinical trial
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Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease : a randomized clinical trial. / Ringbæk, Thomas; Green, Allan; Laursen, Lars Christian; Frausing, Ejvind; Brøndum, Eva; Ulrik, Charlotte Suppli.
I: International Journal of Chronic Obstructive Pulmonary Disease, Bind 10, Nr. 1, 2015, s. 1801-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease
T2 - a randomized clinical trial
AU - Ringbæk, Thomas
AU - Green, Allan
AU - Laursen, Lars Christian
AU - Frausing, Ejvind
AU - Brøndum, Eva
AU - Ulrik, Charlotte Suppli
PY - 2015
Y1 - 2015
N2 - BACKGROUND AND OBJECTIVE: Tele monitoring (TM) of patients with chronic obstructive pulmonary disease (COPD) has gained much interest, but studies have produced conflicting results. Our aim was to investigate the effect of TM with the option of video consultations on exacerbations and hospital admissions in patients with severe COPD.MATERIALS AND METHODS: Patients with severe COPD at high risk of exacerbations were eligible for the study. Of 560 eligible patients identified, 279 (50%) declined to participate. The remaining patients were equally randomized to either TM (n=141) or usual care (n=140) for the 6-month study period. TM comprised recording of symptoms, saturation, spirometry, and weekly video consultations. Algorithms generated alerts if readings breached thresholds. Both groups received standard care. The primary outcome was number of hospital admissions for exacerbation of COPD during the study period.RESULTS: Most of the enrolled patients had severe COPD (forced expiratory volume in 1 second <50%pred in 86% and ≥hospital admission for COPD in the year prior to enrollment in 45%, respectively, of the patients). No difference in drop-out rate and mortality was found between the groups. With regard to the primary outcome, no significant difference was found in hospital admissions for COPD between the groups (P=0.74), and likewise, no difference was found in time to first admission or all-cause hospital admissions. Compared with the control group, TM group patients had more moderate exacerbations (ie, treated with antibiotics/corticosteroid, but not requiring hospital admission; P<0.001), whereas the control group had more visits to outpatient clinics (P<0.001).CONCLUSION: Our study of patients with severe COPD showed that TM including video consultations as add-on to standard care did not reduce hospital admissions for exacerbated COPD, but TM may be an alternative to visits at respiratory outpatient clinics. Further studies are needed to establish the optimal role of TM in the management of severe COPD.
AB - BACKGROUND AND OBJECTIVE: Tele monitoring (TM) of patients with chronic obstructive pulmonary disease (COPD) has gained much interest, but studies have produced conflicting results. Our aim was to investigate the effect of TM with the option of video consultations on exacerbations and hospital admissions in patients with severe COPD.MATERIALS AND METHODS: Patients with severe COPD at high risk of exacerbations were eligible for the study. Of 560 eligible patients identified, 279 (50%) declined to participate. The remaining patients were equally randomized to either TM (n=141) or usual care (n=140) for the 6-month study period. TM comprised recording of symptoms, saturation, spirometry, and weekly video consultations. Algorithms generated alerts if readings breached thresholds. Both groups received standard care. The primary outcome was number of hospital admissions for exacerbation of COPD during the study period.RESULTS: Most of the enrolled patients had severe COPD (forced expiratory volume in 1 second <50%pred in 86% and ≥hospital admission for COPD in the year prior to enrollment in 45%, respectively, of the patients). No difference in drop-out rate and mortality was found between the groups. With regard to the primary outcome, no significant difference was found in hospital admissions for COPD between the groups (P=0.74), and likewise, no difference was found in time to first admission or all-cause hospital admissions. Compared with the control group, TM group patients had more moderate exacerbations (ie, treated with antibiotics/corticosteroid, but not requiring hospital admission; P<0.001), whereas the control group had more visits to outpatient clinics (P<0.001).CONCLUSION: Our study of patients with severe COPD showed that TM including video consultations as add-on to standard care did not reduce hospital admissions for exacerbated COPD, but TM may be an alternative to visits at respiratory outpatient clinics. Further studies are needed to establish the optimal role of TM in the management of severe COPD.
KW - Aged
KW - Algorithms
KW - Ambulatory Care
KW - Anthropometry
KW - Anti-Bacterial Agents
KW - Body Weight
KW - Denmark
KW - Disease Progression
KW - Emergency Service, Hospital
KW - Female
KW - Forced Expiratory Volume
KW - Humans
KW - Lung
KW - Male
KW - Middle Aged
KW - Oximetry
KW - Patient Admission
KW - Predictive Value of Tests
KW - Pulmonary Disease, Chronic Obstructive
KW - Severity of Illness Index
KW - Spirometry
KW - Steroids
KW - Telemedicine
KW - Telemetry
KW - Time Factors
KW - Treatment Outcome
KW - Videoconferencing
U2 - 10.2147/COPD.S85596
DO - 10.2147/COPD.S85596
M3 - Journal article
C2 - 26366072
VL - 10
SP - 1801
EP - 1808
JO - International Journal of COPD
JF - International Journal of COPD
SN - 1176-9106
IS - 1
ER -
ID: 162691495