Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD

Polsky, Michael; Moraveji, Neema; Hendricks, Ashley; Teresi, Robert K; Murray, Richard; Maselli, Diego J.

doi:10.2147/copd.s388049

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…Most recently, Polsky et al ( 44 ) performed a retrospective , non-randomized study on an RPM ‘service’ in patients with COPD which included an undergarment-adhered cardiorespiratory physiologic monitor linked via data capture ‘hub’ to a web-based clinical dashboard. This 2023 study demonstrated that RPM recipients experienced significantly fewer unplanned hospitalizations when compared with usual care.…”

Section: Remote Patient Monitoring and Wearables In Copdmentioning

confidence: 99%

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Coutu,

Iorio,

Ross

2023

Front. Med.

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Chronic obstructive pulmonary disease (COPD) is highly prevalent and is associated with a heavy burden on patients and health systems alike. Exacerbations of COPD (ECOPDs) are a leading cause of acute hospitalization among all adult chronic diseases. There is currently a paradigm shift in the way that ECOPDs are conceptualized. For the first time, objective physiological parameters are being used to define/classify what an ECOPD is (including heart rate, respiratory rate, and oxygen saturation criteria) and therefore a mechanism to monitor and measure their changes, particularly in an outpatient ambulatory setting, are now of great value. In addition to pre-existing challenges on traditional ‘in-person’ health models such as geography and seasonal (ex. winter) impacts on the ability to deliver in-person visit-based care, the COVID-19 pandemic imposed additional stressors including lockdowns, social distancing, and the closure of pulmonary function labs. These health system stressors, combined with the new conceptualization of ECOPDs, rapid advances in sophistication of hardware and software, and a general openness by stakeholders to embrace this technology, have all influenced the propulsion of remote patient monitoring (RPM) and wearable technology in the modern care of COPD. The present article reviews the use of RPM and wearable technology in COPD. Context on the influences, factors and forces which have helped shape this health system innovation is provided. A focused summary of the literature of RPM in COPD is presented. Finally, the practical and ethical principles which must guide the transition of RPM in COPD into real-world clinical use are reviewed.

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Section: Remote Patient Monitoring and Wearables In Copdmentioning

confidence: 99%

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Coutu,

Iorio,

Ross

2023

Front. Med.

View full text Add to dashboard Cite

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Continuous characterisation of exacerbation pathophysiology using wearable technologies in free-living outpatients with COPD: a prospective observational cohort study

Coutu,

Iorio,

Nabavi

et al. 2024

eBioMedicine

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Post-hospitalization remote monitoring for patients with heart failure or chronic obstructive pulmonary disease in an accountable care organization

Harris,

Paynter,

Guinn

et al. 2024

BMC Health Serv Res

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Background Post-hospitalization remote patient monitoring (RPM) has potential to improve health outcomes for high-risk patients with chronic medical conditions. The purpose of this study is to determine the extent to which RPM for patients with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) is associated with reductions in post-hospitalization mortality, hospital readmission, and ED visits within an Accountable Care Organization (ACO). Methods Nonrandomized prospective study of patients in an ACO offered enrollment in RPM upon hospital discharge between February 2021 and December 2021. RPM comprised of vital sign monitoring equipment (blood pressure monitor, scale, pulse oximeter), tablet device with symptom tracking software and educational material, and nurse-provided oversight and triage. Expected enrollment was for at least 30-days of monitoring, and outcomes were followed for 6 months following enrollment. The co-primary outcomes were (a) the composite of death, hospital admission, or emergency care visit within 180 days of eligibility, and (b) time to occurrence of this composite. Secondary outcomes were each component individually, the composite of death or hospital admission, and outpatient office visits. Adjusted analyses involved doubly robust estimation to address confounding by indication. Results Of 361 patients offered remote monitoring (251 with CHF and 110 with COPD), 140 elected to enroll (106 with CHF and 34 with COPD). The median duration of RPM-enrollment was 54 days (IQR 34–85). Neither the 6-month frequency of the co-primary composite outcome (59% vs 66%, FDR p-value = 0.47) nor the time to this composite (median 29 vs 38 days, FDR p-value = 0.60) differed between the groups, but 6-month mortality was lower in the RPM group (6.4% vs 17%, FDR p-value = 0.02). After adjustment for confounders, RPM enrollment was associated with nonsignificantly decreased odds for the composite outcome (adjusted OR [aOR] 0.68, 99% CI 0.25–1.34, FDR p-value 0.30) and lower 6-month mortality (aOR 0.41, 99% CI 0.00–0.86, FDR p-value 0.20). Conclusions RPM enrollment may be associated with improved health outcomes, including 6-month mortality, for selected patient populations.

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Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD

Cited by 4 publications

References 31 publications

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Continuous characterisation of exacerbation pathophysiology using wearable technologies in free-living outpatients with COPD: a prospective observational cohort study

Post-hospitalization remote monitoring for patients with heart failure or chronic obstructive pulmonary disease in an accountable care organization

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