A home telehealth program for patients with severe COPD: The PROMETE study

Calvo, Gonzalo; Gómez‐Suárez, Cristina; Soriano, Joan B.; Zamora, Enrique; González-Gamarra, Amelia; González-Bejar, Milagros; Jordán, Ana; Tadeo, Elena; Sebastián, Alberto; Fernández, Guillermo; Ancochea, Julio

doi:10.1016/j.rmed.2013.12.003

Cited by 123 publications

(131 citation statements)

References 23 publications

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“…Two studies [13,17] only reported data on COPD-related admission. Most studies (6/10) reported a positive effect of telemonitoring on hospitalization for any cause, with risk reductions between 10% [18] and 40% [15], with the noticeable exception of Segrelles et al that reported a risk reduction of 63% [19]. In only three of these positive studies [10,19,20], however, the results reached statistical significance.…”

Section: Effect On Hospital Admissionsmentioning

confidence: 98%

“…Most studies (6/10) reported a positive effect of telemonitoring on hospitalization for any cause, with risk reductions between 10% [18] and 40% [15], with the noticeable exception of Segrelles et al that reported a risk reduction of 63% [19]. In only three of these positive studies [10,19,20], however, the results reached statistical significance. One study [21] reported an increase in hospitalizations in the telemonitored group, with an average number of hospitalizations per patients in the follow-up period (4 months) of 0.38 in the telemonitoring group and 0.14 in the control group.…”

Section: Effect On Hospital Admissionsmentioning

confidence: 98%

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Systematic Review of Telemonitoring in COPD: An Update

Pedone

Lelli

2015

Advances in Respiratory Medicine

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Telemedicine may support individual care plans in people with chronic obstructive pulmonary disease (COPD), potentially improving the clinical outcomes. To-date there is no clear evidence of benefit of telemedicine in this patients. The aim of this study is to provide an update on the effectiveness of telemedicine in reducing adverse clinical outcomes. We searched the Pubmed database for articles published between January 2005 and December 2014. We included only randomized controlled trials exclusively focused on patients with COPD and with a telemedicine intervention arm. Evaluated outcomes were number of exacerbations, ER visits, COPD hospitalizations, length of stay and death. We eventually included 12 randomized controlled trials. Most of them had a small sample size and was of poor quality, with a wide heterogeneity in the parameters and technologies used. Most studies reported a positive effect of telemonitoring on hospitalization for any cause, with risk reductions between 10% and 63%; however only three studies reached statistical significance. The same trend was observed for COPD-related hospital admission and ER visits. No significative effects of telemedicine was evidenced in reducing length of hospital stay, improving quality of life and reducing deaths.In conclusion, our study confirms that the available evidence on the effectiveness of telemedicine in COPD does not allow to draw definite conclusions; most evidence suggests a positive effect of telemonitoring on hospital admissions and ER visits. More trials with adequate sample size and with adequate consideration of background clinical services are needed to definitively establish its effectiveness.

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Section: Effect On Hospital Admissionsmentioning

confidence: 98%

Section: Effect On Hospital Admissionsmentioning

confidence: 98%

Systematic Review of Telemonitoring in COPD: An Update

Pedone

Lelli

2015

Advances in Respiratory Medicine

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“…More recent touch screen tele-monitoring equipment with integrated questionnaires was used with the same frequency [45]. Other authors used stand-alone spirometers [31,50] with modem transmission three times a week in COPD patients under long-term oxygen therapy (LTOT). PEDONE et al [37] used commercial cellular phones coupled with sensors allowing for five measurements of each parameter over 3 h. MAIOLO et al [42] monitored nocturnal SpO 2 twice a week.…”

Section: Equipment and Technology For Follow-upmentioning

confidence: 99%

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

Ambrosino¹,

et al. 2016

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The estimated prevalence of ventilator-dependent individuals in Europe is 6.6 per 100 000 people. The increasing number and costs of these complex patients make present health organisations largely insufficient to face their needs. As a consequence, their burden lays mostly over families. The need to reduce healthcare costs and to increase safety has prompted the development of tele-monitoring for home ventilatory assistance.

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“…Dos estudios de telemonitorización en domicilio de pacientes con EPOC mostraron diferentes resultados. En uno se redujeron los ingresos hospitalarios (62% en grupo control vs. 33% en grupo telemedicina) además de las visitas a urgencias, el tiempo de hospitalización y la necesidad de ventilación mecánica no invasiva 50 . En el otro, por el contrario, aumentaron no significativamente tanto los pacientes hospitalizados (14% en grupo control vs. 21% en grupo monitorizado) como la derivación al especialista (4,8 vs. 16,7%), mientras disminuyeron las visitas a urgencias (33 vs. 17%) 48 .…”

Section: Tecnologías De La Información Y De La Comunicación (Tic)unclassified

The patient and the crossing between Primary and Hospital care. Systematic review of trials for the implementation of tools for integration in Spain

Corral‐Gudino

Cengotita-Bengoa

Sánchez

et al. 2017

An Sist Sanit Navar

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revisiones0el paciente y su travesía entre la atención primaria y la hospitalaria. revisión sistemática de ensayos clínicos para la implementación de herramientas para la integración en españa Fundamento. Los servicios de salud evolucionan hacia la integración, con el fin de reducir la fragmentación de la atención, mejorando la eficiencia y los resultados en salud. Este trabajo valora la efectividad de distintas herramientas para la integración en España. Método. Revisión en MEDLINE (última búsqueda: 31 de julio de 2017) de ensayos clínicos realizados en España. El riesgo de sesgo se valoró utilizando la propuesta de la colaboración Cochrane. resultados. Se incluyeron veintiún estudios: hospitalización a domicilio (cuatro estudios, 455 pacientes), consultas externas mediante videoconferencia (tres, 2438), enfermeras de enlace (cuatro, 1051), mejora del autocuidado (cuatro, 1219), monitorización de parámetros biomédicos en domicilio (tres, 162), uso de aplicaciones informáticas (dos, 225) y conciliación de la medicación (uno, 172). La hospitalización a domicilio, las enfermeras de enlace y la mejora del autocuidado redujeron los reingresos en pacientes ancianos, con insuficiencia cardiaca (IC) o enfermedad pulmonar obstructiva crónica (EPOC). La mejora del autocuidado y las enfermeras de enlace disminuyeron la mortalidad en IC. La hospitalización a domicilio disminuyó los días de hospitalización en EPOC. La mejora del autocuidado redujo el número de visitas a consulta en asma. La consulta externa mediante videoconferencia disminuyó el tiempo hasta el diagnóstico y el tratamiento en áreas rurales. La calidad de la evidencia fue baja o muy baja ya que los estudios tenían dos o más riesgos de sesgo. Conclusiones. La aplicación de herramientas para la integración mejoró algunos resultados en salud en pacientes con enfermedades crónicas, aunque la evidencia es escasa. De todas las herramientas cabe destacar la mejoría en los resultados conseguida con el autocuidado. Palabras clave. Continuidad del cuidado. Cuidado en atención primaria. Hospital a domicilio. Auto-cuidado. Pacientes no ingresados. ABsTrACTBackground. Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. This study estimates the effectiveness in of different tools for integrated care in Spain. Methods. We performed a systematic review of articles using MEDLINE (last search July31 st , 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment.

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A home telehealth program for patients with severe COPD: The PROMETE study

Abstract: We conclude that HT in elderly, severe COPD patients with multiple comorbidities is safe and efficacious in reducing healthcare resources utilization.

Cited by 123 publications

References 23 publications

Systematic Review of Telemonitoring in COPD: An Update

Systematic Review of Telemonitoring in COPD: An Update

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

The patient and the crossing between Primary and Hospital care. Systematic review of trials for the implementation of tools for integration in Spain

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