title: Efficacy of multiparametric telemonitoring on respiratory outcomes in elderly people with COPD: a randomized controlled trial.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with a high health care resource consumption and health care expenditures, driven mainly by exacerbations-related hospitalizations. Telemedicine has been proposed as a mean for timely detection of exacerbation, but the available evidence is inadequate to provide conclusive information on its efficacy. The aim of this study is to evaluate the efficacy of a telemonitoring system in reducing COPD-related hospitalizations in an elderly population with COPD.
  
  
  METHODS
  This is a parallel arms, randomized trial including patients aged 65 or older with COPD in GOLD stages II and III enrolled in a Pulmonary Medicine outpatient facility. Patients were randomly assigned to receive a non-invasive system able to telemonitor vital signs (oxygen saturation, heart rate, near-body temperature, overall physical activity) or standard care, and were followed up for 9 months. The outcome measures were the number of exacerbations and exacerbation-related hospitalization.
  
  
  RESULTS
  Fifty patients were included in the telemonitoring group and 49 in the control group. The incidence rate of respiratory events was 28/100 person/years in the telemonitoring group vs. 42/100 person/years in the control group (incidence rate ratio: 0.67, 95% CI: 0.32 - 1.36). The corresponding figures for hospital admissions where 13/100 person/years and 20/100 person/years, respectively (IRR: 0.66, 95% CI: 0.21 - 1.86).
  
  
  CONCLUSIONS
  In our study, COPD patients followed up with the aid of a multiparametric remote monitoring system experienced a lower rate of exacerbations and COPD-related hospitalizations compared to patients followed up using the standard model of care. These results need to be replicated in larger studies before they can be applied to the general COPD population.
  
  
  BACKGROUND
  NCT01481506 (clinicaltrials.gov).
  
  
  BACKGROUND
  co-financed by Lazio Region and Intersistemi Inc.
authors.affiliation: Area di Geriatria, Università Campus Biomedico, Roma, Italy. c.pedone@unicampus.it
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.forename: Domenica
authors.initials: D
authors.lastname: Chiurco
authors.forename: Simone
authors.initials: S
authors.lastname: Scarlata
authors.forename: Raffaele Antonelli
authors.initials: RA
authors.lastname: Incalzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D017216:Telemedicine; D016896:Treatment Outcome