A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO
A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO
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DOI：
10.4104/pcrj.2011.00057
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发表时间：
2011-09-01
影响因子：
--
通讯作者：
Marno, Penny
中科院分区：
文献类型：
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作者：
Halpin, David M. G.;Laing-Morton, Tish;Marno, Penny
背景资料：我们已经开发了一个冬季预测服务，预测COPD患者的急性加重的风险较高，并通过自动电话提醒他们Aims：To assess the effect of the service and its ability to predict periods of increased risk.Methods：A 4 month prospective randomized controlled trial using clinical criteria and the EXACT PRO questionnaire to identify acquisitions.患者被随机分配接受报警电话。所有患者每天在BlackBerry智能手机上完成日记，包括EXACT PRO问卷。他们进行了接触和评估，如果他们出现恶化。结果：79例患者参加，40个收到警报电话。在预测的高风险期间，每例患者每周的加重频率显著更高（0.086 +/- 0.010 vs 0.055 +/- 0.010）。接受报警电话的患者的急性加重频率（平均值的标准误，SEM）较低（0.95 +/- 0.27 vs 1.17 +/- 0.29），但无统计学显著性。与对照组相比，接受警报呼叫的患者中发生1起或多起EXACT事件的患者较少（34% vs 53%，p=0.11），持续时间较短（8.2 +/- 2.0 v10.1 +/- 1.9天，p=0.481），严重程度较轻（AUC 65 +/- 21 v115 +/- 22，p=0.118）。有SGRQ分数groups.Conclusions之间的平均变化（SEM）没有显着差异：预测的能力，预测高风险时期被明确证实。警报呼叫似乎降低了急性加重的频率和严重程度，但这些影响未达到统计学显著性，可能是因为参与者数量、低于预期的急性加重率以及两组患者在出现急性加重时均与患者接触的事实。
Background: We have developed a winter forecasting service to predict when patients with COPD are at higher risk of an exacerbation and alert them via an automated telephone call.Aims: To assess the effect of the service and its ability to predict periods of increased risk.Methods: A 4-month prospective randomised controlled trial using clinical criteria and the EXACT PRO questionnaire to identify exacerbations. Patients were randomly allocated to receive alert calls. All patients completed a diary including the EXACT PRO questionnaire on a BlackBerry Smartphone each day. They were contacted and assessed if they appeared to be exacerbating.Results: 79 patients participated, 40 received alert calls. The exacerbation frequency per patient per week was significantly greater during periods of predicted high risk (0.086 +/- 0.010 v 0.055 +/- 0.010). The exacerbation frequency ( standard error of the mean, SEM) in patients receiving alert calls was lower (0.95 +/- 0.27 v 1.17 +/- 0.29) but this was not statistically significant. Fewer patients receiving alert calls had one or more EXACT event compared to the controls (34% v 53%, p=0.11), their duration was shorter (8.2 +/- 2.0 v10.1 +/- 1.9 days, p=0.481) and they were less severe (AUC 65 +/- 21 v 115 +/- 22, p=0.118). There were no significant differences in the mean change ( SEM) in SGRQ scores between the groups.Conclusions: The ability of the forecast to predict high risk periods was confirmed unequivocally. Alert calls appeared to reduce the frequency and severity of exacerbations but these effects did not reach statistical significance, perhaps because of the number of participants, lower than expected exacerbation rates, and the fact that there was contact with patients in both groups whenever they appeared to be exacerbating.