Elderly patients with COPD require more health care than elderly heart failure patients do in a hospital-based home care setting.
Aged
Data Collection
Female
Heart Failure
/ epidemiology
Home Care Services, Hospital-Based
/ statistics & numerical data
Hospitalization
/ statistics & numerical data
Humans
Male
Patient Acceptance of Health Care
/ statistics & numerical data
Patient Acuity
Pulmonary Disease, Chronic Obstructive
/ epidemiology
Sweden
/ epidemiology
Telemedicine
/ methods
digital pen
exacerbation
home care services
hospital-based
hospitalization
telemedicine
Journal
International journal of chronic obstructive pulmonary disease
ISSN: 1178-2005
Titre abrégé: Int J Chron Obstruct Pulmon Dis
Pays: New Zealand
ID NLM: 101273481
Informations de publication
Date de publication:
2019
2019
Historique:
received:
05
03
2019
accepted:
14
06
2019
entrez:
14
8
2019
pubmed:
14
8
2019
medline:
8
2
2020
Statut:
epublish
Résumé
Elderly patients with advanced stages of COPD or chronic heart failure (CHF) often require hospitalization due to exacerbations. We hypothesized that telemonitoring supported by hospital-based home care (HBHC) would detect exacerbations early, thus, reducing the number of hospitalization. We also speculated that patients with advanced COPD or CHF would present differences regarding exacerbation frequency and the need of HBHC. The Health Diary system, based on digital pen technology, was employed. Patients aged ≥65 years with ≥2 hospitalizations the previous year were included. Exacerbations were categorized and treated as either COPD or CHF exacerbation by an experienced physician. All HBHC contacts (home visits or telephone consultations) were registered. Ninety-four patients with advanced diseases were enrolled (36 COPD and 58 CHF subjects) of which 53 subjects (19 COPD and 34 CHF subjects) completed the 1-year study period. Death was the major reason for not finalizing the study. Compared to the 1-year prior inclusion, the intervention significantly reduced hospitalization. Although COPD subjects were younger with less comorbidity, exacerbations and HBHC contacts were significantly greater in this group. COPD subjects exhibit exacerbations more frequently, mainly due to disease characteristics, thus, demanding much more HBHC.
Sections du résumé
Background
Elderly patients with advanced stages of COPD or chronic heart failure (CHF) often require hospitalization due to exacerbations. We hypothesized that telemonitoring supported by hospital-based home care (HBHC) would detect exacerbations early, thus, reducing the number of hospitalization. We also speculated that patients with advanced COPD or CHF would present differences regarding exacerbation frequency and the need of HBHC.
Methods
The Health Diary system, based on digital pen technology, was employed. Patients aged ≥65 years with ≥2 hospitalizations the previous year were included. Exacerbations were categorized and treated as either COPD or CHF exacerbation by an experienced physician. All HBHC contacts (home visits or telephone consultations) were registered.
Results
Ninety-four patients with advanced diseases were enrolled (36 COPD and 58 CHF subjects) of which 53 subjects (19 COPD and 34 CHF subjects) completed the 1-year study period. Death was the major reason for not finalizing the study. Compared to the 1-year prior inclusion, the intervention significantly reduced hospitalization. Although COPD subjects were younger with less comorbidity, exacerbations and HBHC contacts were significantly greater in this group.
Conclusions
COPD subjects exhibit exacerbations more frequently, mainly due to disease characteristics, thus, demanding much more HBHC.
Identifiants
pubmed: 31406459
doi: 10.2147/COPD.S207621
pii: 207621
pmc: PMC6642647
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1569-1581Déclaration de conflit d'intérêts
H.L.P. has received honoraria for advisory boards/lectures from AstraZeneca, Boehringer Ingelheim, Novartis, Takeda Nycomed, Almirall, Intermune and Roche. H.L.P. reports personal fees from AstraZeneca, Boehringer Ingelheim, Novartis, Takeda Nycomed, Almirall, Intermune, Roche, outside the submitted work. L.L. reports grants from the county council of Region Östergötland and from The European Regional Development Fund, during the conduct of the study. The authors report no other conflicts of interest in this work.
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