Chronic Obstructive Pulmonary Disease Respiratory Chronic obstructive pulmonary disease, unspecified
Conditions
Interventions
For the 'intervention' arm, 200 patients will receive the ability to interact with the Chronic Disease Management Team via the Tm devices following discharge from hospital for an acute exacerbation of
Sponsors
Hywel Dda University Health Board (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 13/02/2015: 1. Hospitalisation or parental treatment for exacerbation of COPD according to the Global Strategy for Diagnosis, Management, and Prevention of COPD (Reference: 2013 GOLD guidelines). 2. Clinical diagnosis of COPD with at least a 10 pack year smoking history and Forced Expiratory Volume 1 second (FEV1)/Forced Vital Capacity (FVC) less than 70% (ratio of 0.7) and FEV1 less than 80% predicted, recorded within the last 2 years. 3. Optimised on inhalers and other drugs used for COPD according to usual care. 4. Capability to use the Tm devices provided (by the patient or his/her carer, including cognitively able to participate). 5. Aged more than 18 years Previous inclusion criteria: 1. Hospitalisation for exacerbation of COPD according to the Global Strategy for Diagnosis, Management, and Prevention of COPD (Reference: 2011 GOLD guidelines). 2. Working diagnosis of COPD with at least a 10 pack-year smoking history. 3. Forced Expiratory Volume (FEV)/Forced Vital Capacity (FVC) less than 80% and FEV1 less than 70% 4. Optimised on inhalers 5. Capability to use the telemonitoring devices provided (by the patient or his/her carer, including cognitively able to participate) 6. Men and women over the age of 18 years
Exclusion criteria
Exclusion criteria: 1. Those unwilling or unable to provide written consent 2. Discharged to a locality not covered by the outreach Tm team/hospital (e.g., different geographical area served by another hospital/health institution 3. Discharged to a locality with no mobile phone signal or telephone landline 4. Those unable or unwilling to use Tm after teaching, but prior to installation 5. Clinician's discretion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 13/02/2015: Number of (re)admissions for COPD exacerbations within 1 month between the intervention and the comparator group (i.e. the historical controls). Previous primary outcome measures: Number of (re)admissions for COPD exacerbations within 1 month between the intervention and the comparator groups (i.e. the prospective and historical controls). | — |
Secondary
| Measure | Time frame |
|---|---|
| Assessed 12 months after recruitment Clinical outcomes: 1. Number of admissions (any admission during 12 months) 2. Number of bed days (days of hospitalization) 3. Number of Primary Care professional contacts 4. Number of visits to Emergency Department 5. Number of outpatient visits (consultant or specialist nurse) 6. Other healthcare contacts specific for the region healthcare organization (eg. community specialist nurse, district nurse, etc) 7. Duration of use of the telemedicine device Organisational impact: 1. Effects on work processes 2. Effect on structural outcomes 3. Staff perception Economic outcome - the mean/median costs per person. Patient perception - acceptability of the use of Tm by patients in the intervention group | — |
Countries
United Kingdom
Outcome results
None listed