Impact of Telemonitoring With Exacerbation Prediction Algorithm Versus Telemonitoring Alone on Hospitalizations and Health-Related Quality of Life in Patients With COPD

Unreported and untreated exacerbations of COPD have significant negative impacts on health status, disease progression, rate of hospitalization, and readmission. The present study investigated whether a COPD exacerbation prediction algorithm embedded into a telemonitoring system can reduce the numbe...

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Published inRespiratory care Vol. 70; no. 8; p. 954
Main Authors Kronborg, Thomas, Hangaard, Stine, Laursen, Sisse Heiden, Hæsum, Lisa Korsbakke Emtekær, Egmose, Julie, Bender, Clara, Secher, Pernille Heyckendorff, Hejlesen, Ole, Udsen, Flemming Witt
Format Journal Article
LanguageEnglish
Published United States 01.08.2025
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ISSN1943-3654
DOI10.1089/respcare.12611

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Abstract Unreported and untreated exacerbations of COPD have significant negative impacts on health status, disease progression, rate of hospitalization, and readmission. The present study investigated whether a COPD exacerbation prediction algorithm embedded into a telemonitoring system can reduce the number of hospitalizations and improve health-related quality of life (HRQOL) compared with telemonitoring alone. A total of 137 participants were enrolled in this single-blinded randomized controlled trial. Patients were eligible for inclusion if they had a COPD diagnosis, were adults, had fixed residence in Aalborg Municipality in Denmark, and already used an existing telemonitoring system. The primary outcome was the between-group difference in the number of acute hospitalizations per subject after 6 months of follow-up. Secondary outcomes included the difference in all-cause hospitalization, HRQOL measured by 12-item Short Form Health Survey (version 2) and EuroQol-5 Dimension Questionnaire (EQ-5D-5L), and mortality after 6 months. Data were analyzed according to the intention-to-treat principle. The adjusted incidence rate ratio (IRR) of acute hospitalizations per subject was 1.30 (95% CI 0.50-3.38). The odds ratio (OR) for the hospitalization proportion was 2.10 (95% CI: 0.72-6.09). The adjusted IRR for the number of all-cause hospitalizations were 1.25 (95% CI: 0.51-3.07), whereas the OR for an all-cause hospitalization proportion was 1.92 (95% CI: 0.70-5.26). The adjusted OR for mortality was 0.46 (95% CI: 0.11-1.94). The adjusted mean difference in the physical component score and mental component score was 0.77 (95% CI: -1.72 to 3.47) and 0.91 (95% CI: -2.63 to 4.72), respectively, and -0.05 (95% CI: -0.14 to 0.03) for the EQ-5D index score. All results were nonstatistically significant. No definitive conclusions could be drawn regarding the effect on hospitalizations and HRQOL when implementing a COPD prediction algorithm in addition to telemonitoring.
AbstractList Unreported and untreated exacerbations of COPD have significant negative impacts on health status, disease progression, rate of hospitalization, and readmission. The present study investigated whether a COPD exacerbation prediction algorithm embedded into a telemonitoring system can reduce the number of hospitalizations and improve health-related quality of life (HRQOL) compared with telemonitoring alone. A total of 137 participants were enrolled in this single-blinded randomized controlled trial. Patients were eligible for inclusion if they had a COPD diagnosis, were adults, had fixed residence in Aalborg Municipality in Denmark, and already used an existing telemonitoring system. The primary outcome was the between-group difference in the number of acute hospitalizations per subject after 6 months of follow-up. Secondary outcomes included the difference in all-cause hospitalization, HRQOL measured by 12-item Short Form Health Survey (version 2) and EuroQol-5 Dimension Questionnaire (EQ-5D-5L), and mortality after 6 months. Data were analyzed according to the intention-to-treat principle. The adjusted incidence rate ratio (IRR) of acute hospitalizations per subject was 1.30 (95% CI 0.50-3.38). The odds ratio (OR) for the hospitalization proportion was 2.10 (95% CI: 0.72-6.09). The adjusted IRR for the number of all-cause hospitalizations were 1.25 (95% CI: 0.51-3.07), whereas the OR for an all-cause hospitalization proportion was 1.92 (95% CI: 0.70-5.26). The adjusted OR for mortality was 0.46 (95% CI: 0.11-1.94). The adjusted mean difference in the physical component score and mental component score was 0.77 (95% CI: -1.72 to 3.47) and 0.91 (95% CI: -2.63 to 4.72), respectively, and -0.05 (95% CI: -0.14 to 0.03) for the EQ-5D index score. All results were nonstatistically significant. No definitive conclusions could be drawn regarding the effect on hospitalizations and HRQOL when implementing a COPD prediction algorithm in addition to telemonitoring.
Author Kronborg, Thomas
Laursen, Sisse Heiden
Hæsum, Lisa Korsbakke Emtekær
Hangaard, Stine
Bender, Clara
Hejlesen, Ole
Udsen, Flemming Witt
Secher, Pernille Heyckendorff
Egmose, Julie
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Keywords telemedicine
pulmonary disease
Denmark
chronic obstructive
comparative effectiveness research
disease risk prediction
machine learning
exacerbation
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StartPage 954
SubjectTerms Aged
Algorithms
Denmark
Disease Progression
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Prediction Algorithms
Pulmonary Disease, Chronic Obstructive - mortality
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - therapy
Quality of Life
Single-Blind Method
Surveys and Questionnaires
Telemedicine
Title Impact of Telemonitoring With Exacerbation Prediction Algorithm Versus Telemonitoring Alone on Hospitalizations and Health-Related Quality of Life in Patients With COPD
URI https://www.ncbi.nlm.nih.gov/pubmed/40192545
Volume 70
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