Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
Telemed J E Health. 2012 Oct;18(8):634-40. doi: 10.1089/tmj.2011.0231. Epub 2012 Sep 7.
Remote in-home monitoring (RM) of symptoms and physiological variables may allow early detection and treatment of exacerbations of chronic obstructive pulmonary disease (COPD). It is unclear whether RM improves patient outcomes or healthcare resource utilization. This study determined whether RM is feasible in patients with COPD and if RM reduces hospital admissions or length of stay (LOS) or improves health-related quality of life (HRQOL).
Forty-four patients were randomized to standard best practice care (SBP) (n=22) or SBP+RM (n=22). RM involved daily recording of physiological variables, symptoms, and medication usage.
There were no differences (mean±SD, SBP versus SBP+RM) in age (68±8 versus 70±9 years), gender (male:female 10:12 in both groups), or previous computer familiarity (59% versus 50%) between groups. The SBP group had a lower forced expiratory volume in 1 s (0.66±0.24 versus 0.91±0.34 L, p<0.01) and more current smokers (six versus none, p<0.05). There were no differences in number of COPD-related admissions/year (1.5±1.8 versus 1.3±1.7, p=0.76), COPD-related LOS days/year (15.6±19.4 versus 11.4±19.6, p=0.66), total admissions/year (2.2±2.1 versus 2.0±2.3, p=0.86), total LOS days/year (22.1±29.9 versus 21.6±30.4, p=0.88), or HRQOL between the two groups.
The addition of RM to SBP was feasible but did not reduce healthcare utilization or improve quality of life in this group of patients already receiving comprehensive respiratory care.
远程居家监测症状和生理变量可实现慢性阻塞性肺疾病（COPD）恶化的早期检测和治疗。目前尚不清楚远程居家监测是否能改善患者结局或利用医疗资源。本研究旨在确定 COPD 患者中远程居家监测是否可行，以及其是否能减少住院次数或住院时间（LOS）或改善健康相关生活质量（HRQOL）。
44 名患者随机分为标准最佳实践护理（SBP）组（n=22）或 SBP+RM 组（n=22）。RM 包括每日记录生理变量、症状和药物使用情况。
两组间在年龄（SBP 组 68±8 岁，SBP+RM 组 70±9 岁）、性别（男性：女性 SBP 组为 10：12，SBP+RM 组为 10：12）或既往计算机熟悉程度（SBP 组为 59%，SBP+RM 组为 50%）方面均无差异。SBP 组用力呼气量 1 秒率（FEV1）较低（0.66±0.24 比 0.91±0.34L，p<0.01），且当前吸烟者更多（6 例比 0 例，p<0.05）。两组 COPD 相关年住院次数（SBP 组 1.5±1.8 次，SBP+RM 组 1.3±1.7 次，p=0.76）、COPD 相关 LOS 天数（SBP 组 15.6±19.4 天，SBP+RM 组 11.4±19.6 天，p=0.66）、年总住院次数（SBP 组 2.2±2.1 次，SBP+RM 组 2.0±2.3 次，p=0.86）、年总 LOS 天数（SBP 组 22.1±29.9 天，SBP+RM 组 21.6±30.4 天，p=0.88）或 HRQOL 均无差异。
在已经接受全面呼吸护理的患者中，在 SBP 的基础上增加 RM 是可行的，但并未减少医疗保健的利用或改善生活质量。
