A home telehealth service for patients with severe COPD. The PROMETE study

GOAL: To establish the efficacy of a home telehealth service in patients with severe COPD, measured as the reduction in the number of hospitalisations, the length of hospital stay, A&E visits and deaths, due to COPD exacerbations. MATERIALS AND METHODS: The PROMETE study is a randomised controlled trial including two groups, conventional healthcare and another home telehealth, with 30 patients participating in each group. The trial was performed by the Pneumology Department from the Hospital Universitario La Princesa (Madrid, Spain) and coordinated with four local Primary Care Centers. Telehealth equipment, home service, technical assistance and specialized telehealth triage center was provided by Air Products Healthcare. Patients included in the trial suffered severe COPD, GOLD stage IV, with at least an exacerbation episode that leaded to hospitalization in the year prior to inclusion in the trial. Vital signs like blood pressure, heart rate, blood oxygen saturation and pick-flow where monitored in a daily bases. RESULTS: In the first three months of monitoring, 74 red alerts (clinical alerts) were detected. These alerts were evaluated upon severity and immediate clinical response was activated. The intervention group (home telehealth) experienced 10 A&E visits, 6 hospital admissions (with 44 cumulative days of stay), and 1 death due to a COPD exacerbations. While the control group experienced 30 A&E visits, 21 hospital admissions (with 239 cumulative days of stay) and 3 deaths. CONCLUSIONS: Home Telehealth Services are effective in the follow-up of patients with severe COPD, and considerably reduce the number of hospital admissions and A&E visits, as compared with the control group.