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Mínguez Clemente P, Pascual-Carrasco M, Mata Hernández C, Malo de Molina R, Arvelo LA, Cadavid B, López F, Sánchez-Madariaga R, Sam A, Trisan Alonso A, Valle Falcones M, Aguilar Pérez M, Muñoz A, Pérez de la Cámara S, Burgos A, López Viña A, Ussetti Gil P. Follow-up with Telemedicine in Early Discharge for COPD Exacerbations: Randomized Clinical Trial (TELEMEDCOPD-Trial). COPD 2020; 18:62-69. [PMID: 33307857 DOI: 10.1080/15412555.2020.1857717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The results reported by different studies on telemonitoring in patients with chronic obstructive pulmonary disease (COPD) have been contradictory, without showing clear benefits to date. The objective of this study was to ascertain whether an early discharge and home hospitalization telehealth program for patients with COPD exacerbation is as effective as and more efficient than a traditional early discharge and home hospitalization program. A prospective experimental non-inferiority study, randomized into two groups (telemedicine/control) was conducted. The telemedicine group underwent monitoring and was required to transmit data on vital constants and ECGs twice per day, with a subsequent telephone call and 2 home visits by healthcare staff (intermediate and at discharge). The control group received daily visits. The main variable was time until first exacerbation. The secondary variables were: number of exacerbations; use of healthcare resources; satisfaction; quality of life; anxiety-depression; and therapeutic adherence, measured at one and 6 months of hospital discharge. A total of 116 patients were randomized (58 to each group) without significant differences in baseline characteristics or time until first exacerbation, i.e. median 48 days (pp. 25-75:23-120) in the control group, and 47 days (pp. 25-75:19-102) in the intervention group; p = 0.52). A significant decrease in the number of visits was observed in the intervention versus the control group, 3.8 ± 1 vs 5.1 ± 2(p = 0.001), without significant differences in the number of exacerbations. In conclusion follow-up via a telemedicine program in early discharge after hospitalization is as effective as conventional home follow up, being the cost of either strategy not significantly different.
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Affiliation(s)
- P Mínguez Clemente
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Pascual-Carrasco
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - C Mata Hernández
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - R Malo de Molina
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - L A Arvelo
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - B Cadavid
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - F López
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - R Sánchez-Madariaga
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A Sam
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - A Trisan Alonso
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Valle Falcones
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Aguilar Pérez
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - A Muñoz
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - S Pérez de la Cámara
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A Burgos
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A López Viña
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - P Ussetti Gil
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
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