Effectiveness of Telemonitoring in Patients with Chronic Obstructive Pulmonary Disease in Taiwan-A Randomized Controlled Trial

Te-Wei Ho, Chun-Ta Huang, Herng-Chia Chiu, Sheng-Yuan Ruan, Yi-Ju Tsai, Chong-Jen Yu, Feipei Lai, HINT Study Group, Yu-Feng Lin, Hung-Bin Tsai, Nin-Chieh Hsu, Chia-Lin Tseng, Chin-Chung Shu, Wen-Je Ko, Jin-Shing Chen, Te-Wei Ho, Chun-Ta Huang, Herng-Chia Chiu, Sheng-Yuan Ruan, Yi-Ju Tsai, Chong-Jen Yu, Feipei Lai, HINT Study Group, Yu-Feng Lin, Hung-Bin Tsai, Nin-Chieh Hsu, Chia-Lin Tseng, Chin-Chung Shu, Wen-Je Ko, Jin-Shing Chen

Abstract

Chronic obstructive pulmonary disease (COPD) is the leading cause of death worldwide, and poses a substantial economic and social burden. Telemonitoring has been proposed as a solution to this growing problem, but its impact on patient outcome is equivocal. This randomized controlled trial aimed to investigate effectiveness of telemonitoring in improving COPD patient outcome. In total, 106 subjects were randomly assigned to the telemonitoring (n = 53) or usual care (n = 53) group. During the two months following discharge, telemonitoring group patients had to report their symptoms daily using an electronic diary. The primary outcome measure was time to first re-admission for COPD exacerbation within six months of discharge. During the follow-up period, time to first re-admission for COPD exacerbation was significantly increased in the telemonitoring group than in the usual care group (p = 0.026). Telemonitoring was also associated with a reduced number of all-cause re-admissions (0.23 vs. 0.68/patient; p = 0.002) and emergency room visits (0.36 vs. 0.91/patient; p = 0.006). In conclusion, telemonitoring intervention was associated with improved outcomes among COPD patients admitted for exacerbation in a country characterized by a small territory and high accessibility to medical services. The findings are encouraging and add further support to implementation of telemonitoring as part of COPD care.

Figures

Figure 1. Study flow diagram.
Figure 1. Study flow diagram.
Figure 2. Kaplan-Meier curves showing the probability…
Figure 2. Kaplan-Meier curves showing the probability of readmission with COPD exacerbation.
COPD, chronic obstructive pulmonary disease.
Figure 3. Kaplan-Meier curves showing the probability…
Figure 3. Kaplan-Meier curves showing the probability of emergency room visit with COPD exacerbation.
COPD, chronic obstructive pulmonary disease.

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Source: PubMed

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