Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients

Cristóbal Esteban,1,2 Javier Moraza,1 Milagros Iriberri,3 Urko Aguirre,2,4 Begoña Goiria,5 José M Quintana,2,4 Myriam Aburto,1 Alberto Capelastegui1 1Pneumology Department, Galdakao-Usansolo Hospital, Galdakao, 2Red de Investigación en Servicios Sanitario...

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Main Authors: Esteban C, Moraza J, Iriberri M, Aguirre U, Goiria B, Quintana JM, Aburto M, Capelastegui A
Format: Article
Language:English
Published: Dove Medical Press 2016-11-01
Series:International Journal of COPD
Subjects:
Online Access:https://www.dovepress.com/outcomes-of-a-telemonitoring-based-program-telepoc-in-frequently-hospi-peer-reviewed-article-COPD
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author Esteban C
Moraza J
Iriberri M
Aguirre U
Goiria B
Quintana JM
Aburto M
Capelastegui A
author_facet Esteban C
Moraza J
Iriberri M
Aguirre U
Goiria B
Quintana JM
Aburto M
Capelastegui A
author_sort Esteban C
collection DOAJ
description Cristóbal Esteban,1,2 Javier Moraza,1 Milagros Iriberri,3 Urko Aguirre,2,4 Begoña Goiria,5 José M Quintana,2,4 Myriam Aburto,1 Alberto Capelastegui1 1Pneumology Department, Galdakao-Usansolo Hospital, Galdakao, 2Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, 3Pneumology Department, Cruces Hospital, Barakaldo, 4Research Unit, Galdakao-Usansolo Hospital, Galdakao, 5Primary Care Unit, Barrualde Integrated Healthcare Organisation (OSI-Barrualde), Spain Background: The increasing prevalence of chronic diseases requires changes in health care delivery. In COPD, telemedicine appears to be a useful tool. Our objective was to evaluate the efficacy (in improving health care-resource use and clinical outcomes) of a telemonitoring-based program (telEPOC) in COPD patients with frequent hospitalizations. Materials and methods: We conducted a nonrandomized observational study in an intervention cohort of 119 patients (Galdakao-Usansolo Hospital) and a control cohort of 78 patients (Cruces Hospital), followed up for 2 years (ClinicalTrials.gov identifier: NCT02528370). The inclusion criteria were two or more hospital admissions in the previous year or three or more admissions in the previous 2 years. The intervention group received telemonitoring plus education and controls usual care. Results: Most participants were men (13% women), and the sample had a mean age of 70 years, forced expiratory volume in 1 second of 45%, Charlson comorbidity index score of 3.5, and BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index score of 4.1. In multivariate analysis, the intervention was independently related to lower rates of hospital admission (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.27–0.54; P<0.0001), emergency department attendance (OR 0.56, 95% CI 0.35–0.92; P<0.02), and 30-day readmission (OR 0.46, 95% CI 0.29–0.74; P<0.001), as well as cumulative length of stay (OR 0.58, 95% CI 0.46–0.73; P<0.0001). The intervention was independently related to changes in several clinical variables during the 2-year follow-up. Conclusion: An intervention including telemonitoring and education was able to reduce the health care-resource use and stabilize the clinical condition of frequently admitted COPD patients. Keywords: COPD, hospitalizations, telemonitoring program
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spelling doaj.art-091c5713211746bd9eba756af0e803082022-12-22T03:36:20ZengDove Medical PressInternational Journal of COPD1178-20052016-11-01Volume 112919293030184Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patientsEsteban CMoraza JIriberri MAguirre UGoiria BQuintana JMAburto MCapelastegui ACristóbal Esteban,1,2 Javier Moraza,1 Milagros Iriberri,3 Urko Aguirre,2,4 Begoña Goiria,5 José M Quintana,2,4 Myriam Aburto,1 Alberto Capelastegui1 1Pneumology Department, Galdakao-Usansolo Hospital, Galdakao, 2Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, 3Pneumology Department, Cruces Hospital, Barakaldo, 4Research Unit, Galdakao-Usansolo Hospital, Galdakao, 5Primary Care Unit, Barrualde Integrated Healthcare Organisation (OSI-Barrualde), Spain Background: The increasing prevalence of chronic diseases requires changes in health care delivery. In COPD, telemedicine appears to be a useful tool. Our objective was to evaluate the efficacy (in improving health care-resource use and clinical outcomes) of a telemonitoring-based program (telEPOC) in COPD patients with frequent hospitalizations. Materials and methods: We conducted a nonrandomized observational study in an intervention cohort of 119 patients (Galdakao-Usansolo Hospital) and a control cohort of 78 patients (Cruces Hospital), followed up for 2 years (ClinicalTrials.gov identifier: NCT02528370). The inclusion criteria were two or more hospital admissions in the previous year or three or more admissions in the previous 2 years. The intervention group received telemonitoring plus education and controls usual care. Results: Most participants were men (13% women), and the sample had a mean age of 70 years, forced expiratory volume in 1 second of 45%, Charlson comorbidity index score of 3.5, and BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index score of 4.1. In multivariate analysis, the intervention was independently related to lower rates of hospital admission (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.27–0.54; P<0.0001), emergency department attendance (OR 0.56, 95% CI 0.35–0.92; P<0.02), and 30-day readmission (OR 0.46, 95% CI 0.29–0.74; P<0.001), as well as cumulative length of stay (OR 0.58, 95% CI 0.46–0.73; P<0.0001). The intervention was independently related to changes in several clinical variables during the 2-year follow-up. Conclusion: An intervention including telemonitoring and education was able to reduce the health care-resource use and stabilize the clinical condition of frequently admitted COPD patients. Keywords: COPD, hospitalizations, telemonitoring programhttps://www.dovepress.com/outcomes-of-a-telemonitoring-based-program-telepoc-in-frequently-hospi-peer-reviewed-article-COPDCOPDhospitalizationstelemonitoring program.
spellingShingle Esteban C
Moraza J
Iriberri M
Aguirre U
Goiria B
Quintana JM
Aburto M
Capelastegui A
Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
International Journal of COPD
COPD
hospitalizations
telemonitoring program.
title Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
title_full Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
title_fullStr Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
title_full_unstemmed Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
title_short Outcomes of a telemonitoring-based program (telEPOC) in frequently hospitalized COPD patients
title_sort outcomes of a telemonitoring based program telepoc in frequently hospitalized copd patients
topic COPD
hospitalizations
telemonitoring program.
url https://www.dovepress.com/outcomes-of-a-telemonitoring-based-program-telepoc-in-frequently-hospi-peer-reviewed-article-COPD
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