Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, 53179Silkeborg Regional Hospital, Silkeborg, Denmark.
Department of Medicine, 53165Viborg Regional Hospital, Viborg, Denmark.
Chron Respir Dis. 2023 Jan-Dec;20:14799731231157771. doi: 10.1177/14799731231157771.
Patients with chronic obstructive pulmonary disease (COPD) often experience severe physical limitations and psychological distress, which can lead to a deterioration in quality of life (QoL). Telemonitoring (TM) may improve QoL and reduce the number of hospitalizations and readmissions, but results from previous studies have been conflicting. The aim of this study was to assess the effect of TM on QoL in patients with moderate to severe COPD recruited during hospitalization for acute exacerbation (AECOPD).
We conducted a randomized controlled trial at Silkeborg and Viborg Regional Hospitals in Denmark. Participants were recruited during hospitalization for AECOPD and randomized to a six-month telemonitoring service in addition to standard COPD care or standard COPD care alone. Patients were followed for 24 months. QoL was measured by the Hospital Anxiety and Depression Scale (HADS), and St Georges Respiratory Questionnaire (SGRQ) at 3-, 6-, 12-, and 24-months follow-up. The main outcome was QoL at 6 months.
In total, 101 patients were randomized to the TM intervention and 97 to standard care. The between-group difference in SGRQ at 6 months was -2.0 (-8.5; 4.5), in HADS-Anxiety -0.3 (-2.0; 1.4) and in HADS-depression 0.2 (-1.0; 1.4) corresponding to no significant difference in health-related QoL for patients receiving TM compared to standard care. No difference was seen at 12-24 months follow-up either.
TM in addition to standard care did not improve QoL in patients with moderate to severe COPD. Other means of improving management and QoL in severe COPD are urgently needed.
患有慢性阻塞性肺疾病(COPD)的患者通常会经历严重的身体限制和心理困扰,这可能导致生活质量(QoL)恶化。远程监测(TM)可能会改善 QoL 并减少住院和再入院的次数,但之前的研究结果存在冲突。本研究旨在评估 TM 对因急性加重期(AECOPD)住院的中重度 COPD 患者的 QoL 的影响。
我们在丹麦锡尔克堡和维堡地区医院进行了一项随机对照试验。参与者在因 AECOPD 住院期间被招募,并随机分配到为期六个月的远程监测服务,外加标准 COPD 护理或仅标准 COPD 护理。患者随访 24 个月。QoL 通过医院焦虑和抑郁量表(HADS)和圣乔治呼吸问卷(SGRQ)在 3、6、12 和 24 个月随访时进行测量。主要结局是 6 个月时的 QoL。
共有 101 名患者被随机分配到 TM 干预组,97 名患者被分配到标准护理组。6 个月时 SGRQ 的组间差异为-2.0(-8.5;4.5),HADS-焦虑为-0.3(-2.0;1.4),HADS-抑郁为 0.2(-1.0;1.4),这表明接受 TM 治疗的患者与接受标准护理的患者的健康相关 QoL 无显著差异。在 12-24 个月的随访中也没有差异。
TM 加标准护理并未改善中重度 COPD 患者的 QoL。迫切需要其他改善严重 COPD 管理和 QoL 的方法。