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

Abstract:

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.

journal_name

Arch Bronconeumol

authors

Marcos PJ,Represas Represas C,Ramos C,Cimadevila Álvarez B,Fernández Villar A,Fraga Liste A,Fernández Nocelo S,Quiles Del Río J,Zamarrón Sanz C,Golpe R,Abal Arca J,Calvo Álvarez U,Pértega S,García Comesaña J

doi

10.1016/j.arbres.2020.05.030

subject

Has Abstract

pub_date

2020-06-26 00:00:00

eissn

0300-2896

issn

1579-2129

pii

S0300-2896(20)30186-1

pub_type

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