Tele-monitoring reduces exacerbation of COPD in the context of climate change–a randomized controlled trial

Environmental Health

Research

Gavin Donaldson¹  Dieter Scherer²  Christian Witt³  Melissa Jehn³  Uta Liebers³  Bahar Kiran³  Wilfried Endlicher⁴  Klaus Mueller⁵ 

[1] Centre for Respiratory Medicine, Royal Free & UCL Medical School, London, UK;Department of Ecology, Technische Universität Berlin; on behalf of the UCaSH Research Unit, Berlin, Germany;Division of Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin, Berlin, Germany;Geography Department, Humboldt-Universität zu Berlin; on behalf of the KLIMZUG Research Group, Berlin, Germany;Institut for Social Economy, Leibniz-Zentrum für Agrarlandschaftsforschung e.V.; on behalf of the KLIMZUG Research Group, Berlin, Germany;

关键词: Climate change;    Telemedicine;    Heat stress;    Exacerbation frequency;    Activity monitoring;   

DOI  :  10.1186/1476-069X-12-99

 received in 2013-09-16, accepted in 2013-11-15,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundA 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).MethodsSixty-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).ResultsFrom 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).ConclusionHeat 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.Trial registrationDRKS-ID: DRK00000705.

【 授权许可】

CC BY   
© Jehn et al.; licensee BioMed Central Ltd. 2013