Hyldgaard Charlotte, Ringbæk Thomas, Andersen Frank Dyekjær, Hansen Ejvind Frausing, Jensen Michael Skov, Fenger-Grøn Morten, Trolle Christian, Ulrik Charlotte Suppli
Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg/Viborg, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Int J Chron Obstruct Pulmon Dis. 2025 Jul 11;20:2361-2369. doi: 10.2147/COPD.S528852. eCollection 2025.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious events with high morbidity and mortality. Previous studies investigated telemonitoring as a tool for prevention of hospitalizations with ambiguous results. The aim of the present study was to combine data from two randomized controlled trials conducted in Denmark in similar healthcare settings to explore number of hospitalizations for COPD, days of admission, and exacerbations treated outside hospitals.
Recruitment took place during hospitalization for AECOPD and from outpatient COPD clinics. Patients were equally randomized to telemonitoring (N=251) in addition to usual care for six months or usual care alone (N=252). We used a negative binomial regression model with between-group comparisons expressed as incidence rate ratios (IRRs) for assessment of hospitalizations, admission days and moderate exacerbations and Kaplan-Meier time-to-event analysis for assessment of time to first COPD hospitalization.
No significant differences between the two studies were identified. In combined analyses, numerically fewer hospitalizations (IRR 0.85, 95% CI 0.62-1.17) and hospitalization days (IRR 0.72, 95% CI 0.42-1.23) were seen in the telemonitoring group, but the findings did not reach statistical significance whereas treatment for moderate exacerbations was significantly more frequent in the telemonitoring group (IRR 1.91, 95% CI 1.49-2.45).
No effect of telemonitoring on hospitalizations for AECOPD was documented in this large cohort of patients with severe COPD. However, the telemonitoring group received significantly more treatment for moderate exacerbations. This risk of overtreatment should be considered when telemonitoring is used in the care of patients with COPD.
慢性阻塞性肺疾病急性加重（AECOPD）是严重事件，具有高发病率和死亡率。既往研究将远程监测作为预防住院的一种工具，但结果不明确。本研究的目的是合并在丹麦类似医疗环境中进行的两项随机对照试验的数据，以探讨慢性阻塞性肺疾病（COPD）的住院次数、住院天数以及院外治疗的急性加重情况。
在AECOPD住院期间和门诊COPD诊所招募患者。患者被随机分为两组，一组（N = 251）除接受六个月的常规治疗外还接受远程监测，另一组（N = 252）仅接受常规治疗。我们使用负二项回归模型，组间比较以发病率比（IRR）表示，用于评估住院次数、住院天数和中度急性加重情况；使用Kaplan-Meier事件发生时间分析评估首次COPD住院时间。
两项研究之间未发现显著差异。在合并分析中，远程监测组在数值上住院次数较少（IRR 0.85，95%CI 0.62 - 1.17）和住院天数较少（IRR 0.72，95%CI 0.42 - 1.23），但这些结果未达到统计学显著性，而远程监测组中度急性加重的治疗明显更频繁（IRR 1.91，95%CI 1.49 - 2.45）。
在这个大量重度COPD患者队列中，未记录到远程监测对AECOPD住院情况有影响。然而，远程监测组接受中度急性加重治疗的次数明显更多。在COPD患者护理中使用远程监测时，应考虑这种过度治疗的风险。
