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A multicentre, randomized controlled trial of telehealth for the management of COPD

Soriano JB (1), García-Río F (2), Vázquez-Espinosa E (3), Conforto JI (4), Hernando-Sanz A (5), López-Yepes L (6), Galera-Martínez R (7), Peces-Barba G (8), Gotera-Rivera CM (9), Pérez-Warnisher MT (10), Segrelles-Calvo G (11), Zamarro C (12), González-Ponce P (13), Ramos MI (14), Jafri S (15), Ancochea J (16).

(1) Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.
(2) Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
(3) Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.
(4) Linde Healthcare, Spain.
(5) Servicio de Neumología, Hospital 12 de Octubre, Madrid, Spain.
(6) Servicio de Neumología, Hospital 12 de Octubre, Madrid, Spain.
(7) Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
(8) Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
(9) Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
(10) Departamento de Neumología, Clínica Universidad de Navarra, Madrid, Spain.
(11) Servicio de Neumología, Hospital Rey Juan Carlos, Móstoles, Spain.
(12) Servicio de Neumología, Hospital Rey Juan Carlos, Móstoles, Spain.
(13) Monitoring Centre for Remote Patient Monitoring, Linde Healthcare, Madrid, Spain.
(14) Linde Healthcare, Spain.
(15) Linde Healthcare, Germany.
(16) Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.

Revisão:Respiratory Medicine

Data: 13/Out/2018

Pneumologia

BACKGROUND:

Evidence is needed to determine the role of telehealth (TH) in COPD management.

METHODS:

PROMETE II was a multicentre, randomized, 12-month trial. Severe COPD patients in stable condition were randomized to a specific monitoring protocol with TH or routine clinical practice (RCP). The primary objective was to reduce the number of COPD exacerbations leading to ER visits/hospital admissions between groups.

RESULTS:

Overall, 237 COPD patients were screened, and 229 (96.6%) were randomized to TH (n = 115) or RCP (n = 114), with age of 71 ± 8 years and 80% were men. Overall, 169 completed the full follow-up period. There were no statistical differences at one year between groups in the proportion of participants who had a COPD exacerbation (60% in TH vs. 53.5% in RCP; p = 0.321). There was, however, a marked but non-significant trend towards a shorter duration of hospitalization and days in ICU in the TH group (18.9 ± 16.0 and 6.0 ± 4.6 days) compared to the RCP group (22.4 ± 19.5 and 13.3 ± 11.1 days). The number of all-cause deaths was comparable between groups (12 in TH vs. 13 in RCP) as was total resource utilization cost (7912€ in TH vs. 8918€ in RCP). Telehealth was evaluated highly positively by patients and doctors.

CONCLUSIONS:

Remote patient management did not reduce COPD-related ER visits or hospital admissions compared to RCP within 12 months.

CITAÇÃO DO ARTIGO  Respir Med. 2018 Nov;144:74-81. doi: 10.1016/j.rmed.2018.10.008.

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