title: A home telehealth program for patients with severe COPD: the PROMETE study.
abstract: BACKGROUND
  Acute exacerbations of chronic obstructive pulmonary disease (AECOP) are key events in the natural history of the disease. Patients with more AECOPD have worse prognosis. There is a need of innovative models of care for patients with severe COPD and frequent AECOPD, and Telehealth (TH) is part of these programs.
  
  
  METHODS
  In a cluster assignment, controlled trial study design, we recruited 60 patients, 30 in home telehealth (HT) and 30 in conventional care (CC). All participants had a prior diagnosis of COPD with a post-bronchodilator forced expiratory volume (FEV1)% predicted <50%, age ≥ 50 years, were on long-term home oxygen therapy, and non-smokers. Patients in the HT group measured their vital signs on a daily bases, and data were transmitted automatically to a Clinical Monitoring Center for followed-up, and who escalated clinical alerts to a Pneumologist.
  
  
  RESULTS
  After 7-month of monitoring and follow-up, there was a significant reduction in ER visits (20 in HT vs. 57 in CC), hospitalizations (12 vs. 33), length of hospital stay in (105 vs. 276 days), and even need for non-invasive mechanical ventilation (0 vs. 8), all p < 0.05. Time to the first severe AECOPD increased from 77 days in CC to 141 days in HT (K-M p < 0.05). There was no study withdrawals associated with technology. All patients showed a high level of satisfaction with the HT program.
  
  
  CONCLUSIONS
  We conclude that HT in elderly, severe COPD patients with multiple comorbidities is safe and efficacious in reducing healthcare resources utilization.
authors.affiliation: Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain. Electronic address: gsegrelles@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Segrelles Calvo
authors.affiliation: Linde Healthcare, The Linde Group, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Gómez-Suárez
authors.affiliation: Epidemiology and Clinical Research Program, CIMERA, Bunyola, Illes Balears, Spain.
authors.forename: J B
authors.initials: JB
authors.lastname: Soriano
authors.affiliation: Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Zamora
authors.affiliation: Goya Primary Care Center, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gónzalez-Gamarra
authors.affiliation: Montesa Primary Care Center, Spain.
authors.forename: M
authors.initials: M
authors.lastname: González-Béjar
authors.affiliation: Linde Healthcare, The Linde Group, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Jordán
authors.affiliation: Linde Healthcare, The Linde Group, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Tadeo
authors.affiliation: Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sebastián
authors.affiliation: Department of Medical Research and Documentation, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Fernández
authors.affiliation: Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ancochea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
keywords: COPD; Comorbidities; Elderly; Hospitalizations; Telehealth; Telemedicine