Lung function assessed by home forced oscillation and self reported symptoms during COPD exacerbations

Pompilio, Pasquale Pio, Macis, Roberta, Isetta, Valentina , Munaro, Giulia, Walker, Paul, Castellani, Angelo Paulo, Dalmase, Mireia, Middlemass, Jo, Siriwardena, A. Niroshan, Zanaboni, Paulo, Sepper, Ruth, Prikk, Kaiu, Malinovschi, Andrei, Janson, Christer, Marušiç, Dorjan, Dolgan, Tatjana, Dellaca, Raffaele L., Calverley, Peter M. A. and Rosso, Roberto (2015) Lung function assessed by home forced oscillation and self reported symptoms during COPD exacerbations. The European Respiratory Journal : official journal of the European Society for Clinical Respiratory Physiology, 46 (Supp59). 5.2-5.2. ISSN 0903-1936

Lung function assessed by home forced oscillation and self reported symptoms during COPD exacerbations
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CHROMED (clinical trials for elderly people with multiple diseases, is an EU-funded project involving 9 partners from 7 European countries aimed at evaluating the impact of a new home care approach to reduce costs and improve quality of life in elderly patients with COPD and comorbidity. The trial involves 300 patients with a prior history of exacerbations randomly assigned to a monitoring or observational arm. Monitored patients performed daily self-assessment of lung mechanics with a FOT (Forced Oscillation Technique) device (RESMON PRO DIARY, Restech srl, Italy) and completed a symptom diary card on touchscreen device (HOME PATIENT MONITOR, EBM srl, Italy). Any detected worsening in lung mechanics generated an alert triggering a phone interview directed at verifying the patient's status and optimizing treatment.

By the end of March 2015, 70 monitored patients had completed the trial resulting in 16198 measurements with an adherence of 90.1%. Based on lung mechanics, 311 worsening events were detected, resulting in 0.65±0.3 alerts/patient/month. At least one major symptom (dyspnea, sputum purulence and volume) was reported in 70% of events and 41% were associated with an exacerbation according to diary cards (Seemungal et al., Am J Respir Crit Care Med 1998). A total of 77 exacerbations were confirmed during the phone interview and treated, but 48% of them were not associated with an exacerbation defined by diary cards only.

These results suggest that a significant percentage of exacerbations cannot be identified by diary cards only. Self-assessment of lung mechanics using FOT provides complementary information which can be useful to manage COPD patients at home.

Additional Information:
Keywords:multimorbidity, Chronic Obstructive Pulmonary Disease, telemedicine, randomised controlled trial, pilot study, COPD-management, exacerbation, primary care, general practice, NotOAChecked
Subjects:H Engineering > H123 Public Health Engineering
A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
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ID Code:22474
Deposited On:15 Mar 2016 14:07

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