Digital Interventions to reduce hospitalization and hospital readmission for chronic obstructive pulmonary disease (COPD) patient: systematic review

Abstract

Background The high readmission rate following chronic obstructive pulmonary disease (COPD) has created a significant global health challenge, with high healthcare costs and a growing burden of care. Digital interventions, including telemonitoring, Telehealth, web, or mobile-based, can address these challenges, but there has yet to be a systematic review of the impact of digital interventions on reducing hospital readmission for patients with COPD. The aim of this systematic review was to assess the effectiveness of digital interventions in lowering hospitalization and rehospitalization for patients with COPD. Methods We conducted a systematic literature search from PubMed and Scopus to identify randomized controlled trials (RCTs) published in English with outcomes related to hospital admission or readmission within 30 days of hospital discharge. Results The search and selection process followed PRISMA guidelines and resulted in a final sample of 12 RCTs. We found mixed results. Of the 12 included studies, only four studies [mobile-based (n=1), Telehealth (n=1), Telemonitoring (n=2)] found positive effect of a digital intervention on hospital readmission. Seven studies [mobile-based (n=1), Telehealth (n=1), Telemonitoring (n=3), Web-based (n=2)] did not demonstrate clear evidence of a significant reduction in hospitalization rate. Based on these findings, the primary factors contributing to the outcome variation were differences in intervention components used and their operator, COPD severity, patient age, and sample size. Conclusions Systematic review provides the first insight into the impact of digital intervention on hospital readmission among patients with COPD . While some studies showed positive results, the evidence is mixed, and further research is needed. COVID-19 has accelerated the use of digital intervention and created the opportunity for comprehensive research and investigation with more updated information and further impact on readmission.