Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease: a randomized clinical trial

Figures & data

Table 1 Baseline characteristic of the patients (n=281) enrolled in the tele health care study divided according to the group assignment

	Tele monitoring, N=141	Controls, N=140	P-value
Females, N (%)	86 (61%)	63 (45%)	0.007
Age, years	69.8 (9.0)	69.4 (10.1)	0.75
BMI, kg/m^2	24.9 (6.3)	26.9 (7.0)	0.013
FEV1 %pred	34.9 (13.3)	33.8 (12.0)a	0.48
MRC dyspnea score, mean (range)	3.5 (2–5)	3.7 (1–5)	0.09
Current smokers, N (%)	35 (24.8%)	47 (33.6%)	0.10
Pack years, mean (range) (N=133/116)b	42.9 (0–210)	41.0 (0–110)	0.72
Long-term oxygen therapy, N (%)	37 (26.2%)	38 (27.1%)	0.86
Charlson Comorbidity Index	1.70 (1.49)	1.96 (1.51)	0.13
Living alone, %	57.9%	52.2%	NS
Hospital admissions for COPD exacerbation in the year prior to enrollment, mean (range)	1.41 (0–7)	1.22 (0–23)	0.61
Medication for COPD, N (%)
Oral prednisolonec	10 (7.1%)	14 (10.0%)	0.68
Roflumilast	8 (5.7%)	5 (3.6%)	0.39
Inhaled corticosteroids	129 (91.5%)	128 (91.4%)	0.57
Long-acting antimuscarinic agents	131 (92.9%)	120 (85.7%)	0.99
Long-acting β2-agonists	134 (95.0%)	136 (97.1%)	0.54

Notes: Values are mean (and standard deviation) unless otherwise specified. All P-values are comparisons between the TM and control group.

a Data missing for one patient;

b data missing for patients 8 and 24, respectively.

c maintenance therapy.

Abbreviations: FEV₁, forced expiratory volume in 1 second; MRC, Medical Research Council; TM, tele monitoring; NS, not significant.

Figure 1 Flowchart of patients with COPD identified as eligible for inclusion into the study investigating the effect of add-on tele health care, including video consultations, to standard care on hospital admissions for COPD.

Table 2 Frequency and characteristics of acute exacerbations, hospital admissions, and visits to emergency rooms and outpatient clinics for tele monitored patients and controls

	Tele monitoring, N=141	Controls, N=140	P-value
Hospital admission for COPD exacerbation, mean (range)	0.55 (0–5)	0.54 (0.4)	0.74
All cause hospital admissions, mean (range)	1.19 (0–12)	1.31 (0–9)	0.28
At least one hospitalization (any cause), %	46.8%	51.4%	0.44
Length of stay, all-cause hospital admissions (days), mean (range)	5.35 (0–71)	5.29 (0–53)	0.38
At least one COPD exacerbation requiring hospital admission, %	29.1%	31.4%	0.67
Length of stay, COPD hospital admissions (days), mean (range)	1.76 (0–52)	2.02 (0–31)	0.51
Exacerbation of COPD not requiring hospital admission,a mean (range)	1.21 (0–17)	0.73 (0–8)	0.001
At least one exacerbation of COPD not requiring hospitalizationa	58.2%	37.1%	<0.001
Visits to the emergency room, mean (range)	0.11 (0–3)	0.16 (0–2)	0.12
Visits to the respiratory outpatient clinic, mean (range)	0.26 (0–3)	0.99 (0–7)	<0.001
Visits to nonrespiratory outpatient clinics, mean (range)	1.34 (0–12)	1.41 (0–10)	0.43

Note:

a An exacerbation was defined as a worsening of COPD symptoms requiring treatment with a rescue course of systemic corticosteroids and/or antibiotics.

Figure 2 Hospital admission for COPD during the 6-month study period for patients randomized to tele health care + standard care (TM group, n=141) vs standard care (control group, n=140).

Abbreviation: TM, tele monitoring.

Figure 3 All-cause hospital admission during the 6-month study period for patients randomized to tele health care + standard care (TM group, n=141) vs standard care (control group, n=140).

Abbreviation: TM, tele monitoring.