A randomised trial of telemedicine-based treatment versus conventional hospitalisation in patients with severe COPD and exacerbation - effect on self-reported outcome.

ABSTRACT

We investigated self-reported outcome in patients with COPD and exacerbation. Consecutive patients were randomised to an intervention group with home telemedicine and a control group who had conventional hospital admission. We assessed Health-Related Quality of Life (HRQoL) using the St George's Respiratory Questionnaire, daily activity using Instrumental Activity of Daily Living, anxiety and depression using the Hospital Anxiety and Depression Scale, and self-assessed cognitive decline using Subjective Cognitive Functioning. Data were collected at 3 days, 6 weeks and 3 months after discharge. There were 22 patients in each group. Their baseline characteristics were similar a mean age of 70 years, FEV1 42% predicted and oxygen saturation 95%. After 6 weeks, FEV1 had improved in both groups, to 1.2 L in the intervention group and 1.0 L in the control group. Oxygen saturation had improved in the intervention group from 94% to 96%. Regarding HRQoL, there was a non-significant (P = 0.05) improvement in the symptom score in favour of the control group, but the improvement was not maintained after three months. However, there were no significant differences in self-reported outcomes in COPD patients with exacerbation treated at home via telemedicine versus conventionally in hospital.