Effect of Telemedicine on Outcomes for Patients With COPD

The use of telemedicine could be an alternative to visits at respiratory outpatient clinics for patients with severe chronic obstructive pulmonary disease (COPD), according to a study published in the International Journal of COPD.

Danish researchers equally randomized 281 patients into either usual care or telemonitoring, which included recording of symptoms, saturation, spirometry, and weekly video consultations, for a 6-month study period. The purpose of the study was to investigate the effect of telemonitoring on exacerbations and hospital admissions for patients with severe COPD.

“Tele monitoring (TM) has gained enormous interest because it is seen not only as a way of providing prompt medical intervention in the early phase of deterioration in the patient’s condition and by that prevent hospital admissions but also as a way of reducing costs and time spend with transportation,” the researchers wrote.

The majority of the patients in the study had severe COPD with nearly half (45%) having at least 1 hospital admission for COPD in the year prior to enrollment in the study.

Patients assigned to the telemedicine group were scheduled for 7 video consultations during the 6-month study period. Plus, measurements without video consultation were taken 3 times a week for the first 4 weeks and once a week for the remainder of the study period. Plus, patients were free to perform additional measurements or phone a call center, and unscheduled video consultations could be arranged if necessary.

At the end of the study, there was no significant difference in hospitals admissions for COPD between the 2 groups, and no difference in time to first admission or all-cause hospital admission. The TM group had more moderate exacerbations, which were treated with antibiotics or corticosteroids and didn’t need hospital admissions. Meanwhile the control group had more visits to outpatient clinics.

“TM with close contact between the patient and the health care providers at the hospital and the possibility of monitoring for early signs of COPD exacerbations leads to an increase in number of exacerbations treated outside the hospital setting, whereas TM had no significant impact on hospitalizations or mortality,” the authors wrote.