Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica/terapia , Telemedicina/economía , Telemedicina/métodos , Anciano , Anciano de 80 o más Años , Femenino , Servicios de Atención de Salud a Domicilio/organización & administración , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , EspañaRESUMEN
BACKGROUND: Evidence is needed to determine the role of telehealth (TH) in COPD management. METHODS: PROMETE II was a multicentre, randomized, 12-month trial. Severe COPD patients in stable condition were randomized to a specific monitoring protocol with TH or routine clinical practice (RCP). The primary objective was to reduce the number of COPD exacerbations leading to ER visits/hospital admissions between groups. RESULTS: Overall, 237 COPD patients were screened, and 229 (96.6%) were randomized to TH (nâ¯=â¯115) or RCP (nâ¯=â¯114), with age of 71⯱â¯8 years and 80% were men. Overall, 169 completed the full follow-up period. There were no statistical differences at one year between groups in the proportion of participants who had a COPD exacerbation (60% in TH vs. 53.5% in RCP; pâ¯=â¯0.321). There was, however, a marked but non-significant trend towards a shorter duration of hospitalization and days in ICU in the TH group (18.9⯱â¯16.0 and 6.0⯱â¯4.6 days) compared to the RCP group (22.4⯱â¯19.5 and 13.3⯱â¯11.1 days). The number of all-cause deaths was comparable between groups (12 in TH vs. 13 in RCP) as was total resource utilization cost (7912 in TH vs. 8918 in RCP). Telehealth was evaluated highly positively by patients and doctors. CONCLUSIONS: Remote patient management did not reduce COPD-related ER visits or hospital admissions compared to RCP within 12 months.