Chronic Obstructive Pulmonary Disease Respiratory Chronic Obstructive Pulmonary Disease
Conditions
Interventions
Our proposed research will study innovative telemedicine technology which will allow us to monitor patients non-invasively in their own homes for the 3 months following discharge. This technology will
Sponsors
Aintree University NHS Foundation Trust (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Trial participants will be recruited from University Hospital Aintree, at the point of their intended discharge following standard care during their initial admission prior to participation in the trial. Selection criteria will be broadly inclusive to maximise external validity. Participants must have: 1. A confirmed diagnosis of COPD 2. Be at the point of discharge from hospital following an exacerbation of COPD, excluding patients who require NIV acutely during the admission 3. Patients discharged with support from the HAH team will also be included as this is currently standard practice within the trust 4. Have and are able to use a telephone 5. Are able to use the telemedicine device and peripherals at entry 6. The age range will be between 40-100yrs of both gender
Exclusion criteria
Exclusion criteria: 1. Participation in this trial after a previous admission 2. Current participation in another clinical trial 3. Patients who require NIV acutely during the admission or chronically 4. A diagnosis of pneumonia on the current admission 5. Serious uncontrolled co-morbidity and situations where the intervention would clearly be inappropriate such as where end of life care is being provided 5. Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Feasibility of the protocol: Our intention is to perform a much larger study following this pilot study with defined outcome measures. For the purposes of this pilot study these outcome measures will be assessed as far as is practicable, with the added intention of assessing feasibility of the study as well acceptability of the intervention to participants and/or their carer's. | — |
Secondary
| Measure | Time frame |
|---|---|
| We will determine the clinical effectiveness of the intervention using criteria that are important to people with COPD and the NHS and specifically the effects within three months of discharge on: Number of patients admitted to hospital within 3 months of discharge following an admission for a COPD exacerbation 1. Number of patients admitted to hospital 2. Number of patients admitted to hospital within 3 months of discharge following an admission for a COPD exacerbation 3. Duration of hospital admissions (days per admission and total days within 3 months) 4. Number of patients treated for COPD exacerbations as defined by a step up from their usual maintenance treatment 5. Breathlessness using extended MRC dyspnoea score (administered at 6 weeks and 3 months) 6. Quality of life as measured by the COPD Assessment Test (administered at 6 weeks and 3 months) 7. Days off work due to COPD symptoms (number/participant/month) 8. Anxiety and depression assessed using the Hospital Anxiety and Depression scale, Becker's depression inventory, Becker's hopelessness score (administered at 6 weeks and 3 months) 9. Rate of unscheduled primary care consultations initiated by the patient because of worsening COPD symptoms (number/participant/month) 10. Rate of unscheduled secondary care attendances initiated because of worsening COPD symptoms (mean number of emergency department visits, hospital admissions, and intensive care unit admissions per participant/month) 11. Concordance with the telemedicine and hospital at home interventions assessed using equipment usage logs and hospital at home records 12. Health outcome, as determined by the EQ-5D 13. Patient satisfaction using a semi structured questionnaire Assessed at 6 weeks and 3 months of discharge following a hospital admission for a COPD exacerbation. | — |
Countries
United Kingdom
Outcome results
None listed