Remote Patient Monitoring Improves Outcomes for COPD Patients

Published in the International Journal of Chronic Obstructive Pulmonary Disease, recent research described the various benefits chronic obstructive pulmonary disease (COPD) patients experienced from remote cardiorespiratory monitoring, such as reduced all-cause and cardiopulmonary hospitalization rates.

According to the Centers for Disease Control and Prevention (CDC), COPD affects over 15 million Americans, taking the lives of 150,000 each year. 

According to the study, the Centers for Medicare and Medicaid Services has expressed support for the use of remote patient monitoring (RPM) in chronic disease management, but few studies have examined RPM's ability to reduce the need for unplanned hospitalizations among COPD patients.

This led researchers from the Pulmonary Associates of Richmond, UT Health, and RPM company Spire Health to conduct a study at an outpatient pulmonary practice.

With a cohort of 126 COPD patients, the study included a retrospective analysis of unplanned hospitalizations. The inclusion criteria for the study were participating in an RPM program for at least a year and being a patient of the practice for at least two years.

The RPM service included a Food and Drug Administration-cleared remote physiologic monitor that previously received validation for clinical accuracy and adherence among COPD patients. It also included a system consisting of three components: undergarment-adhered cardiorespiratory sensors, an in-home hub, and a web-based clinical dashboard.

Researchers analyzed the EMR data of patients one year before and after the intervention began, gathering information regarding patients, care encounters, and hospitalizations.

From this review, researchers found that the RPM intervention decreased the frequency of all-cause hospitalizations in the cohort by 65 percent, with hospitalizations dropping from 137 one year before the intervention to 48 one year after.

They also found that the average length of stay during all-cause hospitalizations was 0.60 days shorter following the intervention. But this finding was not statistically significant, the study noted.

Also, cardiopulmonary hospitalizations decreased by 63.6 percent, dropping from 88 to 32. Also, the length of stay during cardiopulmonary hospitalizations was 1.28 days lower after the intervention. But the study states that this difference was also not statistically significant.

Following the intervention, emergency room visits decreased by 44.3 percent, decreasing from 61 to 34.

Further, researchers found that most patients adhered to RPM program requirements 90 percent or more of the 12-month post-initiation period. They defined an adherent day as wearing the sensor for eight hours or more every 24 hours. Although this frequency gradually diminished, the overall adherence per patient was 88.6 percent of days.

Based on these findings, researchers concluded that all-cause hospitalization rates among subjects were lower in the year post-intervention than before.

This study is one example of research examining the use of RPM for COPD care.

Similarly, a collaboration formed in October 2022 aims to determine the efficacy of a virtual care method in treating COPD, leveraging factors such as patient-reported outcomes, healthcare use, and total medical expenditure. The method includes an RPM component, in-home care, and virtual pulmonary rehabilitation.

With plans to enroll 100 adults with the disease, researchers will evaluate these factors over six months. The results of the study will be released in the middle of this year.