Source: International Congress 2016 – Non-inflammatory assessment of airway disorders
Disease area: Airway diseases

Abstract

Consultation intervals of COPD patients are based on judgement of the treating physicians, COPD severity and patient preference. By this, acute exacerbations of COPD (AECOPD) are recognised belatedly. Earlier detection could reduce emergency admissions and hospitalisations. Different studies investigating COPD-management programs supported by telehealthcare (THC) have shown conflicting results. The objective was to test the feasibility and establish THC for COPD.Patients daily answered a questionnaire online, focused on the detection of AECOPD. All data were daily analysed by the study team, who called the patient by phone in case of suspected AECOPD for further evaluation.Of 339 screened patients, 48 (14.2%) were included. Main reason for exclusion was missing technical equipment (27%). Mean age was 63 years; mean follow up was 231 days. Data completeness was 88% (9819/11083 patient days); 94% of patients completed the study. With the current “alarming” system, we identified 60 AECOPD in 22 patients. 2 AECOPD were not detected by this algorithm. The sensitivity of the procedure in detecting AECOPD was 96.8%, specificity 98.3%, positive predictive value 26.1% and negative predictive value 99.9%. We conducted 230 telephone calls in 38 patients.THC for COPD is feasible in a selected subgroup of patients, missing technical equipment being the main exclusion criterion. Eligible patients show excellent compliance and acceptance. The current THC procedure has a high sensitivity and negative predictive value for detecting or excluding AECOPD, while the positive predictive value is low. The last aspect can lead to a disproportional expenditure of time and has to be improved by refining the intervention algorithm.


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Frank Rassouli (St. Gallen, Switzerland), Frank Rassouli, Maurus Pfister, Florent Baty, Sandra Widmer, Martin Brutsche. Telehealthcare in COPD – A feasibility trial. Eur Respir J 2016; 48: Suppl. 60, 1019

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