Randomised Trial of Telehealth Consultations for Nursing Care of Chronic Obstructive Pulmonary Disease (COPD) Patients
Effectiveness of Nurse Lead Telehealth Consultations in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Visão geral do estudo
Descrição detalhada
COPD is among the most common reasons for illness and fatality in adults worldwide, and it is expected that this trend will escalate radically by 2020 (1). Approximately 29% of patients admitted to Hospital with exacerbation will be readmitted within the first month (2), and after one year 46% of patients will have been readmitted on one or more occasions due to exacerbation (3).
Therefore, trials have been carried out using different forms of digitally supported distance health interventions (telehealth nurse consultations) (4) of patients with COPD with a view to reducing the number of readmissions in a reliable way, measured in relation to mortality. Thus in these trials there are a certain indication that use of telehealth nurse consultations of patients with COPD is a treatment initiative that reliably can reduce the number of COPD patients readmitted with exacerbation.
The number of randomized telehealth studies are however few (4;5), and there is a lack of documentation of the effect of telehealth monitoring.
Therefore, a large randomized telehealth study with a clear set up was necessary.
This study is a randomized multicenter trial that will take place at the acute admissions department and lung department at Odense University Hospital,Denmark
We hypothesized that in a period of 26 weeks:
- The total number of readmissions can be reduced with 14%
- The time to the first readmission will be prolonged
- The number of readmissions with exacerbation can be reduced after telehealth consultations as a supplement to the conventional treatment compared with conventional treatment
- The total number of readmission days can be reduced after telehealth consultations as a supplement to the conventional treatment compared with conventional treatment
- The total number of readmission days with exacerbation can be reduced after telehealth consultations as a supplement to the conventional treatment compared with conventional treatment
- The mortality rate will remain unchanged after the telehealth consultations as a supplement to the conventional treatment compared with conventional treatment
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Odense, Dinamarca, 5000
- Odense University Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion criteria:
- Chronic obstructive pulmonary disease (COPD) verified by spirometry.
- Exacerbation in COPD, defined as increased need for medicine, and increased dyspnea or increased expectorate or increased coughing.
- > or 40 years old
- Living on Funen and islands
- Signed informed consent.
Exclusion criteria:
- Not able to communicate via telephone and/or computer screen
- Previously received "The COPD suitcase", or participated in this protocol
- Systolic BT is <100 mm Hg
- Saturation < 90
- Thorax x-ray shows signs of malignant changes or lobar pneumonia
- Diagnosed with cancer or recurrence of cancer within the last five years
- Admitted with septic shock, acute myocardial infarction or other serious medical condition (for example renal disease)
- Diagnosed with heart failure (EF < 30%)
- Refused to participate
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Telehealth consultation
Telehealth nurse consultation plus treatment as usual
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The consultations are structured as outpatient sessions immediately after discharge. The content of the education deals with the regular treatment, prevention of exacerbation and how to live with the illness. The aim of the counseling is to increase the patient's empowerment and competence to take action. The patients have the consultations for 7 days followed by a telephone call. Each session is organized and individualised according to the patient's wishes and needs for education and counselling. The equipment consists of a computer with web camera, microphone and measurement equipment. A button to contact to the nurse at the hospital, an alarm button and a volume button. The results are transferred to the hospital by a secure internet line.
Outros nomes:
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Sem intervenção: Conventional
Treatment as usual
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Prazo |
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The number of readmissions
Prazo: at 26 weeks after discharge
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at 26 weeks after discharge
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Medidas de resultados secundários
Medida de resultado |
Prazo |
|---|---|
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The mortality rate
Prazo: at 26 weeks weeks after discharge
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at 26 weeks weeks after discharge
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The duration to the first readmission
Prazo: at 26 weeks after discharge
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at 26 weeks after discharge
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The number of hospital readmissions with exacerbation
Prazo: at 26 weeks after discharge
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at 26 weeks after discharge
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The number of days readmitted
Prazo: days 26 weeks after discharge
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days 26 weeks after discharge
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The number of days readmitted with exacerbation
Prazo: days 26 weeks after discharge
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days 26 weeks after discharge
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Anne Dichmann Sorknaes, PhD student, University of Southern Denmark
Publicações e links úteis
Publicações Gerais
- Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997 May 24;349(9064):1498-504. doi: 10.1016/S0140-6736(96)07492-2.
- (2) Sundhedsstyrelsen. Genindlæggelser af ældre i Danmark 2008 - Nye tal fra Sundhedsstyrelsen. 1060. Ref Type: Internet Communication.
- Eriksen N, Hansen EF, Munch EP, Rasmussen FV, Vestbo J. [Chronic obstructive pulmonary disease. Admission, course and prognosis]. Ugeskr Laeger. 2003 Sep 8;165(37):3499-502. Danish.
- Casas A, Troosters T, Garcia-Aymerich J, Roca J, Hernandez C, Alonso A, del Pozo F, de Toledo P, Anto JM, Rodriguez-Roisin R, Decramer M; members of the CHRONIC Project. Integrated care prevents hospitalisations for exacerbations in COPD patients. Eur Respir J. 2006 Jul;28(1):123-30. doi: 10.1183/09031936.06.00063205. Epub 2006 Apr 12.
- Finkelstein SM, Speedie SM, Potthoff S. Home telehealth improves clinical outcomes at lower cost for home healthcare. Telemed J E Health. 2006 Apr;12(2):128-36. doi: 10.1089/tmj.2006.12.128.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- UNRS-20100030-2
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