Pulmonary Associates of Richmond, Richmond, VA, USA.
Spire Health, San Francisco, CA, USA.
Int J Chron Obstruct Pulmon Dis. 2023 Mar 3;18:219-229. doi: 10.2147/COPD.S388049. eCollection 2023.
Chronic obstructive pulmonary disease (COPD) is prevalent and results in high healthcare resource utilization. The largest impact on health status and proportion of healthcare costs in COPD are related to hospitalizations for acute exacerbations. Accordingly, the Centers for Medicare & Medicaid Services have advocated for remote patient monitoring (RPM) to aid in chronic disease management. However, there has been a lack of evidence for the effectiveness of RPM in reducing the need for unplanned hospitalizations for patients with COPD.
This pre/post study was a retrospective analysis of unplanned hospitalizations in a cohort of COPD subjects started on RPM at a large, outpatient pulmonary practice. The study included all subjects with at least one unplanned, all-cause hospitalization or emergency room visit in the prior year, who had elected to enroll in an RPM service for assistance with clinical management. Additional inclusion criteria included being on RPM for at least 12 months and a patient of the practice for at least two years (12 months pre- and post-initiation of RPM).
The study included 126 subjects. RPM was associated with a significantly lower rate of unplanned hospitalizations per patient per year (1.09 ± 0.07 versus 0.38 ± 0.06, <0.001).
Unplanned, all-cause hospitalization rates were lower in subjects started on RPM for COPD when compared to their prior year. These results support the potential of RPM to improve the long-term management of COPD.
慢性阻塞性肺疾病（COPD）较为常见，会导致医疗资源的大量消耗。COPD 对健康状况的影响最大，导致医疗成本比例最高的是急性加重住院治疗。因此，医疗保险和医疗补助服务中心（Centers for Medicare & Medicaid Services）提倡远程患者监测（remote patient monitoring，RPM）以辅助慢性疾病管理。然而，在 COPD 患者中，RPM 减少计划外住院需求的有效性缺乏证据。
本研究为一项回顾性分析，纳入了在一家大型门诊肺科诊所开始接受 RPM 的 COPD 患者队列中计划外住院的情况。该研究纳入了所有在前一年中至少有一次计划外、全因住院或急诊就诊的患者，他们选择加入 RPM 服务以协助临床管理。其他纳入标准包括至少接受 12 个月的 RPM 治疗，且为该诊所的患者至少 2 年（在开始 RPM 治疗前和治疗后各 12 个月）。
该研究共纳入 126 名患者。与每年每位患者的计划外住院率（1.09 ± 0.07 次比 0.38 ± 0.06 次，<0.001）相比，RPM 与显著降低计划外住院率相关。
与前一年相比，开始接受 RPM 治疗的 COPD 患者的计划外全因住院率更低。这些结果支持 RPM 改善 COPD 长期管理的潜力。
