ABSTRACT
The results reported by different studies on telemonitoring in patients with chronic obstructive pulmonary disease (COPD) have been contradictory, without showing clear benefits to date. The objective of this study was to ascertain whether an early discharge and home hospitalization telehealth program for patients with COPD exacerbation is as effective as and more efficient than a traditional early discharge and home hospitalization program. A prospective experimental non-inferiority study, randomized into two groups (telemedicine/control) was conducted. The telemedicine group underwent monitoring and was required to transmit data on vital constants and ECGs twice per day, with a subsequent telephone call and 2 home visits by healthcare staff (intermediate and at discharge). The control group received daily visits. The main variable was time until first exacerbation. The secondary variables were: number of exacerbations; use of healthcare resources; satisfaction; quality of life; anxiety-depression; and therapeutic adherence, measured at one and 6 months of hospital discharge. A total of 116 patients were randomized (58 to each group) without significant differences in baseline characteristics or time until first exacerbation, i.e. median 48 days (pp. 25-75:23-120) in the control group, and 47 days (pp. 25-75:19-102) in the intervention group; p = 0.52). A significant decrease in the number of visits was observed in the intervention versus the control group, 3.8 ± 1 vs 5.1 ± 2(p = 0.001), without significant differences in the number of exacerbations. In conclusion follow-up via a telemedicine program in early discharge after hospitalization is as effective as conventional home follow up, being the cost of either strategy not significantly different.
Subject(s)
Pulmonary Disease, Chronic Obstructive , Telemedicine , Follow-Up Studies , Hospitalization , Humans , Patient Discharge , Prospective Studies , Pulmonary Disease, Chronic Obstructive/therapy , Quality of LifeABSTRACT
No disponible
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/epidemiology , Bronchodilator Agents/therapeutic use , Muscarinic Antagonists/therapeutic use , Quality of LifeABSTRACT
La piedra angular del tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC) es la broncodilatación, y en los últimos años se ha desarrollado un importante número de moléculas que han ido cambiando paulatinamente la práctica clínica habitual en estos pacientes. Los fármacos multivalentes con más de un mecanismo de acción broncodilatador representan el próximo paso en materia de relajación del músculo liso bronquial, pero dada la creciente evidencia sobre el estrés oxidativo y estado inflamatorio generalizado de la EPOC, existe una clara tendencia a demostrar el beneficio de formulaciones antiinflamatorias respecto a un potencial control sintomático, y secundariamente la reducción de la importante carga económica que supone el consumo de recursos sanitarios. En este capítulo se pretende dar un resumen esquemático y actualizado sobre los fármacos en investigación en EPOC en las fases previas de su desarrollo clínico
Bronchodilators are the cornerstone of Chronic obstructive pulmonary disease (COPD) treatment, and in the last years an important number of new molecules have changed gradually the clinical practice in these patients. Multivalent drugs with more than one mechanism of action represent the next step in terms of bronchial smooth muscle relaxation, although, giving the growing evidence of oxidative stress and generalized inflammation in COPD, there is a clear tendency to test the potential benefit of new anti-inflammatory drugs for symptoms control in the first place and consequently the reduction of the high economic burden of this disease. This chapter aims to give a schematical and updated review of new drugs for COPD in the preclinical phases of their clinical development
Subject(s)
Humans , Drugs, Investigational/therapeutic use , Pulmonary Disease, Chronic Obstructive/drug therapy , Muscle Relaxation/drug effects , Bronchodilator Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Receptors, Tumor Necrosis Factor/antagonists & inhibitors , Interleukin-1/antagonists & inhibitors , Interleukin-13/antagonists & inhibitors , Interleukins/antagonists & inhibitors , p38 Mitogen-Activated Protein Kinases/antagonists & inhibitors , Phosphodiesterase Inhibitors/therapeutic use , Oxidative Stress/drug effectsABSTRACT
No disponible
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapy , Education, Medical, Continuing/trends , Pulmonary Medicine/educationABSTRACT
No disponible
