Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease: a randomized clinical trial

• Published in: International journal of chronic obstructive pulmonary disease 2015-01, Vol.10 (Issue 1), p.1801-1808
• Main Authors: Ringbæk, Thomas, Green, Allan, Laursen, Lars Christian, Frausing, Ejvind, Brøndum, Eva, Ulrik, Charlotte Suppli
• Format: Article
• Language: English
• Subjects: Admission and discharge; Aged; Algorithms; Ambulatory Care; Anthropometry; Anti-Bacterial Agents - therapeutic use; Body Weight; Call centers; Care and treatment; Chronic obstructive pulmonary disease; Clinics; Denmark; Diagnosis; Disease Progression; Dyspnea; Emergency medical care; Emergency Service, Hospital; Female; Forced Expiratory Volume; Health aspects; Hospitals; Humans; Lung - physiopathology; Lung diseases, Obstructive; Male; Middle Aged; Mortality; Original Research; Outpatient care facilities; Oximetry; Patient Admission; Patient admissions; Portable computers; Predictive Value of Tests; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Quality of life; Severity of Illness Index; Spirometry; Steroids - therapeutic use; Telemedicine; Telemedicine - methods; Telemetry; Time Factors; Treatment Outcome; Videoconferencing
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S85596

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. 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. Most of the enrolled patients had severe COPD (forced expiratory volume in 1 second