2011 Volume 31 Issue 2 Pages 2_24-2_33
Purpose: Using a randomized controlled trial, we aimed to determine the effects of a home monitoring-based telenursing (TN) practice considering two endpoints: preventing acute respiratory exacerbation (primary outcome) and readmission (secondary outcome) among chronic obstructive pulmonary disease (COPD) patients with home oxygen therapy (HOT).
Methods: Thirty-seven COPD HOT patients were randomly assigned to TN experimental group (n=20, mean age 76.0 years) and control group (n=17, mean age 77.7). Experimental group was given usual treatment (UT) by the primary care physician plus daily TN for three months. Controls received only UT for three months.
Results: Experimental group showed significantly higher number of hospitalization bed days before the immediate implementation period. Experimental group acute exacerbations were significantly decreased by TN 32.9%. The onset of acute exacerbation was significantly delayed compared to control group. The frequency of acute exacerbation during the three months was significantly decreased for the experimental group. TN insignificantly decreased readmissions 3.5%. Readmissions during the three months were significantly decreased for the experimental group compared to controls. Acute respiratory exacerbation ratios and readmission rates compared by Kaplan–Meier analysis showed that acute exacerbations were prevented in experimental group.
Conclusions: Home monitoring-based TN has the potential to prevent and decrease the frequency of acute respiratory exacerbations in COPD HOT patients.
