Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is prevalent and results in high healthcare resource utilization. The largest impact on health status and proportion of healthcare costs in COPD are related to hospitalizations for acute exacerbations. Accordingly, the Centers for Medicare & Medicaid Services have advocated for remote patient monitoring (RPM) to aid in chronic disease management. However, there has been a lack of evidence for the effectiveness of RPM in reducing the need for unplanned hospitalizations for patients with COPD.

Methods

This pre/post study was a retrospective analysis of unplanned hospitalizations in a cohort of COPD subjects started on RPM at a large, outpatient pulmonary practice. The study included all subjects with at least one unplanned, all-cause hospitalization or emergency room visit in the prior year, who had elected to enroll in an RPM service for assistance with clinical management. Additional inclusion criteria included being on RPM for at least 12 months and a patient of the practice for at least two years (12 months pre- and post-initiation of RPM).

Results

The study included 126 subjects. RPM was associated with a significantly lower rate of unplanned hospitalizations per patient per year (1.09 ± 0.07 versus 0.38 ± 0.06, P<0.001).

Conclusion

Unplanned, all-cause hospitalization rates were lower in subjects started on RPM for COPD when compared to their prior year. These results support the potential of RPM to improve the long-term management of COPD.

Keywords:

• COPD
• exacerbations
• hospitalizations
• admissions
• remote patient monitoring
• physiology

Abbreviations

COPD, chronic obstructive pulmonary disease; AECOPD, acute exacerbation of COPD; FEV1, forced expiratory volume in the first second; RPM, remote patient monitoring; EMR, electronic medical record; CL, clinical liaison; brpm, breaths per minute; bpm, beats per minute; KS, Kolmogorov–Smirnov.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Neema Moraveji, Ashley Hendricks, Richard Murray, and Robert K Teresi are employees of Spire Health. In addition, Neema Moraveji has a patent (system for physiological monitoring) issued to Spire Health. Richard Murray is currently the Board Chair of the Asthma and Allergy Foundation of America (AAFA). Michael Polsky receives financial support from Spire Health. Diego J Maselli reports personal fees from GSK, AstraZeneca, Sanofi/Regeneron, and Amgen, outside the submitted work. The authors have no other conflicts of interest to disclose for this work.

Additional information

Funding

The study was funded by Spire Health.