Resumen de Impact of a Home Telehealth Program After a Hospitalized COPD Exacerbation: A Propensity Score Analysis
Pedro J. Marcos Rodríguez, Cristina Represas Represas, Cristina Ramos Hernández, Blanca Cimadevila Alvarez, Alberto Fernández Villar, Angélica Fraga Liste, Susana Fernández Nocelo, Javier Quiles del Rio, Carlos Zamarrón Sanz, Rafael Golpe Gómez, José Abal Arca, Uxío Calvo Álvarez, Sonia Pértega Díaz, Julio García Comesaña
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.
