Impact of a Home Telehealth Program After a Hospitalized COPD Exacerbation: A Propensity Score Analysis

• Pedro J. Marcos ^[1] ; Cristina Represas Represas ^[4] ; Cristina Ramos ^[4] ; Blanca Cimadevila Álvarez ^[5] ; Alberto Fernández-Villar ^[6] ; Angélica Fraga Liste ^[5] ; Susana Fernández Nocelo ^[5] ; Javier Quiles del Río ^[5] ; Carlos Zamarrón Sanz ^[7] ; Rafael Golpe ^[8] ; José Abal Arca ^[2] ; Uxío Calvo Álvarez ^[3] ; Sonia Pértega ^[1] ; Julio García Comesaña ^[9]
  1. [1] Instituto de Investigación Biomédica da Coruña

     Instituto de Investigación Biomédica da Coruña

     A Coruña, España

     
  2. [2] Complexo Hospitalario Universitario de Ourense

     Complexo Hospitalario Universitario de Ourense

     Ourense, España

     
  3. [3] Complexo Hospitalario Universitario de Ferrol

     Complexo Hospitalario Universitario de Ferrol

     Ferrol, España

     
  4. [4] Instituto de Investigación Sanitaria Galicia Sur (IISGS), Hospital Álvaro Cunqueiro de Vigo
  5. [5] Servicio Galego de Saude (SERGAS), Santiago de Compostela
  6. [6] Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo
  7. [7] Complejo Hospitalario Universitario de Santiago de Compostela
  8. [8] Hospital Universitario Lucus Augusti de Lugo
  9. [9] Estructura Organizativa Integrada (EOXI) de Vigo

  Mostrar afiliaciones +
• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 58, Nº. 6 (Junio), 2022, págs. 478-481
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Introduction Currently there is lack of data regarding the impact of a home telehealth program on readmissions and mortality rate after a COPD exacerbation-related hospitalization.

    Objective To demonstrate if a tele-monitoring system after a COPD exacerbation admission could have a favorable effect in 1-year readmissions and mortality in a real-world setting.

    Methods This is an observational study where we compared an intervention group of COPD patients treated after hospitalization that conveyed a telehealth program with a followance period of 1 year with a control group of patients evaluated during one year before the intervention began. A propensity-score analyses was developed to control for confounders. The main clinical outcome was 1-year all-cause mortality or COPD-related readmission.

    Results The analysis comprised 351 telemonitoring patients and 495 patients in the control group. The intervention resulted in less mortality or readmission after 12 months (35.2% vs. 45.2%; hazard ratio [HR] 0.71 [95% CI = 0.56–0.91]; p = 0.007). This benefit was maintained after the propensity score analysis (HR = 0.66 [95% CI = 0.51–0.84]). This benefit, which was seen from the first month of the study and during its whole duration, is maintained when mortality (HR = 0.54; 95% CI = [0.36–0.82]) or readmission (subdistribution hazard ratio [SHR] 0.66; 95% CI = [0.50–0.86]) are analyzed separately.

    Conclusion Telemonitoring after a severe COPD exacerbation is associated with less mortality or readmissions at 12 months in a real world clinical setting.