Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality

Hamadi, Hanadi; Martinez, Dayana; Xu, Jing; Silvera, Geoffrey A.; Mallea, Jorge M.; Hamadi, Walaa; Li, Xinmei; Liu, Yueping; Zhao, Mei

doi:10.1177/1357633x20970402

Cited by 6 publications

(4 citation statements)

References 48 publications

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“…In contrast, in the PROMETE II project 32 it was concluded that home telemonitoring did not lead to a decrease in hospital admissions compared with standard practice. Moreover, in a study carried out in the United States, Hamadi et al 33 observed a significant increase in the rate of readmissions at 30 days of COPD patients included in a telemonitoring programme. As demonstrated by the above, there is disparity in the results obtained by these programmes depending on the method used by each working group.…”

Section: Discussionmentioning

confidence: 99%

Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model

Sánchez-Mellado

Villar-Álvarez

Ormaechea

et al. 2022

Open Respiratory Archives

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Section: Discussionmentioning

confidence: 99%

Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model

Sánchez-Mellado

Villar-Álvarez

Ormaechea

et al. 2022

Open Respiratory Archives

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“…Hence, it is important to find ways to prevent the incidence and progression of LRTI in older adults. Previous studies on risk factors associated with LRTI-caused readmission had the following limitations: (1) the duration of follow-up was short, as numerous studies focused on readmission and death within the first 30 days of discharge from the hospital [16][17][18][19][20][21][22], (2) the impact of anemia on LRTI-caused readmission and death was not analyzed. e researchers paid more attention to the effects of nutritional status [7,8], comorbidities [9], gender [2,10], and swallowing dysfunction [11] on LRTI-caused readmission, (3) previous studies on LRTI-caused readmissions have been primarily conducted with patients in the age range of 18-79 years.…”

Section: Discussionmentioning

confidence: 99%

Effect of Anemia on Readmission and Death in Octogenarian Patients with Lower Respiratory Tract Infections: A Retrospective Cohort Study

Chen

Cao

et al. 2022

International Journal of Clinical Practice

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Objectives. Lower respiratory tract infection (LRTI) in the octogenarian population is a highly prevalent disorder associated with increased mortality rates. Anemia is a common disorder in older adults and is often left untreated. We investigated whether anemia was a risk factor for LRTI-caused readmission and death in octogenarian patients. Design. A retrospective cohort study was designed. Participants. Old patients (age: ≥80 years) hospitalized at the Department of Geriatrics to undergo treatment for LRTIs were included. A total of 215 patients (mean age: 88.73 years; 77.2% men) were studied. The patients were divided into two groups (anemia and non-anemia) based on the hemoglobin level. They were followed up for 1 year after discharge or until mortality event. The primary follow-up outcome was LRTI-caused readmission and/or death. Results. The risk of readmission due to LTRI within 1 year of discharge was 2.308 times higher in the anemia group than the risk for the non-anemia group. The number of patients experiencing ≥2 readmissions in the anemia group was significantly higher than that in the non-anemia group (35 (23.5%) vs. 2 (3%), P < 0.001 ). To prevent readmission of one case, only 2.65 cases with anemia needed to be treated. Furthermore, the risk of LRTI-related deaths was 6.644 times higher in the anemia group than the risk for the non-anemia group. To prevent death of one case, only 3.9 cases with anemia needed to be treated. Statistic results revealed that hemoglobin was an independent protective factor for LRTI-caused readmission (logistic regression method, OR, 0.969; 95% CI, 0.950–0.989) and deaths (Cox regression method, β, −0.037, HR, 0.964; 95% CI, 0.934–0.994). Conclusions. Anemia is a widely prevalent and relevant risk factor associated with LRTI-caused readmission and death within 1 year of discharge in octogenarian patients. Trial Registration. This trial is registered with NCT05355324.

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“…Although research on telemonitoring is rapidly growing [11], these systems typically target a singular condition such as diabetes mellitus (DM), hypertension (HT), or heart failure (HF) [12][13][14]. Systematic reviews indicate that telemonitoring for single conditions leads to improved health outcomes and quality of life and reductions in health service use and costs [15][16][17][18][19][20][21]. Studies that do not report improvements do not often include a self-care component, are difficult to use, or do not target patients who are most ill and frequently hospitalized [22][23][24][25].…”

Section: Telemonitoring For the Management Of Chronic Conditionsmentioning

confidence: 99%

Challenges of Telemonitoring Programs for Complex Chronic Conditions: Randomized Controlled Trial With an Embedded Qualitative Study

Ware¹,

Shah²,

Ross³

et al. 2022

J Med Internet Res

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Background Despite the growing prevalence of people with complex conditions and evidence of the positive impact of telemonitoring for single conditions, little research exists on telemonitoring for this population. Objective This randomized controlled trial and embedded qualitative study aims to evaluate the impact on and experiences of patients and health care providers (HCPs) using a telemonitoring system with decision support to manage patients with complex conditions, including those with multiple chronic conditions, compared with the standard of care. Methods A pragmatic, unblinded, 6-month randomized controlled trial sought to recruit 146 patients with ≥1 diagnosis of heart failure (HF), uncontrolled hypertension (HT), and insulin-requiring diabetes mellitus (DM) from outpatient specialty settings in Toronto, Ontario, Canada. Participants were randomized into the control and telemonitoring groups, with the latter being instructed to take readings relevant to their conditions. The telemonitoring system contained an algorithm that generated decision support in the form of actionable self-care directives to patients and alerts to HCPs. The primary outcome was health status (36-Item Short Form Health Survey questionnaire). Secondary outcomes included anxiety and depression, self-efficacy in chronic disease management, and self-reported health service use. HF-related quality of life and self-care measures were also collected from patients followed for HF. Within- and between-group change scores were analyzed for statistical significance (P<.05). A convenience sample of HCPs and patients in the intervention group was interviewed about their experiences. Results A total of 96 patients were recruited and randomized. Recruitment was terminated early because of implementation challenges and the onset of the COVID-19 pandemic. No significant within- and between-group differences were found for the main primary and secondary outcomes. However, a within-group analysis of patients with HF found improvements in self-care maintenance (P=.04) and physical quality of life (P=.046). Opinions expressed by the 5 HCPs and 13 patients who were interviewed differed based on the monitored conditions. Although patients with HF reported benefitting from actionable self-care guidance and meaningful interactions with their HCPs, patient and HCP users of the DM and HT modules did not think telemonitoring improved the clinical management of those conditions to the same degree. These differing experiences were largely attributed to the siloed nature of specialty care and the design of the decision support, whereby fluctuations in the status of HT and DM typically required less urgent interventions compared with patients with HF. Conclusions We recommend that future research conceive telemonitoring as a program and that self-management and clinical decision support are necessary but not sufficient components of such programs for patients with complex conditions and lower acuity. We conclude that telemonitoring for patients with complex conditions or within multidisciplinary care settings may be best operationalized through nurse-led models of care. Trial Registration ClinicalTrials.gov NCT03127852; https://clinicaltrials.gov/ct2/show/NCT03127852 International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8367

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Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality

Cited by 6 publications

References 48 publications

Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model

Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model

Effect of Anemia on Readmission and Death in Octogenarian Patients with Lower Respiratory Tract Infections: A Retrospective Cohort Study

Challenges of Telemonitoring Programs for Complex Chronic Conditions: Randomized Controlled Trial With an Embedded Qualitative Study

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