Tele-monitoring reduces exacerbation of COPD in the context of climate change--a randomized controlled trial.
Tele-monitoring reduces exacerbation of COPD in the context of climate change--a randomized controlled trial.
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DOI：
10.1186/1476-069x-12-99
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发表时间：
2013-11-21
期刊：
影响因子：
--
通讯作者：
Witt C
中科院分区：
文献类型：
--
作者：
Jehn M;Donaldson G;Kiran B;Liebers U;Mueller K;Scherer D;Endlicher W;Witt C
开发了一种基于家庭的远程监测系统，以评估热应激（> 25°C的天数）对慢性阻塞性肺疾病（COPD）患者临床和功能状态的影响。将62例COPD患者（GOLD II-IV）随机分为远程监测组（TG，N = 32）和对照组（CG，N = 30）。远程监测包括1）每日临床状态（COPD评估测试-CAT），2）每日肺功能和3）每周6分钟步行测试（6 MWT）。监测持续时间共9个月（9个月）。从2012年6月1日至8月31日，记录了32天的热应激（29.0 ± 2.5°C），并与32天的热舒适（21.0 ± 2.9°C）匹配。在热应激期间，TG表现出肺功能和运动能力的显著降低（FEV1%预测值：51.1 ± 7.2 vs. 57.7 ± 5.0%; P <0.001; 6 MWT性能：452 ± 85 vs. 600 ± 76步; P <0.001）和CAT评分增加（19.2 ± 7.9 vs. 16.2 ± 7.2; P <0.001）。在夏季，TG患者COPD加重的发生率显著低于CG患者（3 vs. 14; P = 0.006）。在整个9个月的随访中，TG组与CG组相比，病情加重较少（7 vs. 22; P = 0.012），累积住院时间较短（34 vs. 97天），专家咨询减少43%（24. 24%）。vs. 42; P = 0.04）。热应激影响COPD的临床和功能状态。远程监测减少了热应激和一年中其他时期的恶化频率和医疗保健利用。 DRKS-ID：DRK00000705。
A home based tele-monitoring system was developed to assess the effects of heat stress (days > 25°C) on clinical and functional status in patients with chronic obstructive pulmonary disease (COPD). Sixty-two COPD patients (GOLD II–IV) were randomized into a tele-monitoring Group (TG, N = 32) or Control Group (CG, N = 30). Tele-monitoring included 1) daily clinical status (COPD Assessment Test-CAT), 2) daily lung function and 3) weekly 6-minute walk test (6MWT). Duration of monitoring lasted a total of nine months (9 M). From June 1st–August 31st 2012, 32 days with heat stress (29.0 ± 2.5°C) were recorded and matched with 32 thermal comfort days (21.0 ± 2.9°C). During heat stress, the TG showed a significant reduction in lung function and exercise capacity (FEV1% predicted: 51.1 ± 7.2 vs. 57.7 ± 5.0%; P <0.001 and 6MWT performance: 452 ± 85 vs. 600 ± 76 steps; P <0.001) and increase in CAT scores (19.2 ± 7.9 vs. 16.2 ± 7.2; P <0.001). Over summer, significantly fewer TG patients suffered exacerbation of COPD compared to CG patients (3 vs. 14; P = 0.006). Over entire 9 M follow-up, the TG group had fewer exacerbations compared to CG (7 vs. 22; P = 0.012), shorter cumulative hospital stay (34 vs. 97 days) and 43% fewer specialist consultations (24. vs. 42; P = 0.04). Heat stress affects clinical and functional status in COPD. Tele-monitoring reduces exacerbation frequency and health care utilization during heat stress and other periods of the year. DRKS-ID: DRK00000705.