Optimised telemedicine for elderly with pulmonary disease
Air is considered life-giving. COPD is a progressive type of obstructive lung disease characterised by long-term poor airflow that makes it difficult to breathe. The condition is often accompanied by other co-morbidities such as chronic heart failure (CHF) and sleep disordered breathing (SDB). Hence, such patients have poor life expectancy as well as poor quality of life. The EU-funded CHROMED (Clinical trials for elderly patients with multiple disease) project investigated the utility of telemedicine-based healthcare models for elderly people with COPD and cardiovascular co-morbidities. Project partners first pilot-tested and optimised their information and communication technology platform. Three devices were used in this platform: a patient monitor, a lung assessment device employing forced oscillation technique, and a wearable device called Wrist Clinic to measure vital parameters. An international multi-centric randomised control trial involving 300 patients was conducted in Estonia, Spain, Slovenia, Sweden and the United Kingdom. These European countries have different social and organisational contexts with well-established procedures for age-related disease management. Patients in the intervention group had lower costs than patients in the control group due to less hospitalisation. In addition, there was no difference in quality-adjusted life-year (QALY), a measure of disease burden that measures both quality and quantity of life. Hospitalisations for acute exacerbation of COPD are the main contributor to the annual cost of COPD. As it is the most expensive chronic disease found in elderly patients, the use of CHROMED in EU healthcare services could lead to massive savings and better optimization of healthcare resources. Although the CHROMED system is still at the prototype stage, the positive results, including ease of use, will facilitate its future use in routine clinical practices. Remote contacts via telemedicine were considered as safe and satisfactory as face-to-face contacts. Therefore, the use of the system by hospitals for disease management of COPD patients with cardiovascular co-morbidities represents a viable and convenient addition to traditional outpatient care. The CHROMED platform will personalise care assistance for elderly patients with multiple diseases and improve their quality of life. This in turn will help reduce the huge socioeconomic burden of COPD and support the sustainability of European health care systems.
Keywords
Chronic obstructive pulmonary disease, telemedicine, CHROMED, cardiovascular co-morbidities, disease management, quality-adjusted life-year
